Pharmacists' perceptions on patient care services and social determinants of health within independent community pharmacies in an enhanced services network

Abstract

BackgroundHealth care is transitioning from fee‐for‐service towards value‐based care. Community pharmacies are providing an increasing number of patient care services (PCS) that improve medication adherence, medication knowledge, and overall patient health. The provision of these services may differ based on the socioeconomic characteristics of the patient population. There is a lack of information on PCS delivery in independent community pharmacies and how these services are provided to underserved populations.ObjectivesThe objectives of this study were to: (a) Evaluate the current level of commitment and readiness of independent community pharmacies in delivering PCS, and (b) Assess community pharmacists' perceptions of addressing social barriers and health disparities among underserved populations.MethodsThis was a cross‐sectional electronic survey distributed to independent community pharmacies who were members of a pharmacy advocacy or PCS organization in New York State.ResultsOne‐hundred and twenty‐five surveys were distributed, with 65 responses (52% response rate) from a high proportion of pharmacy owners (75%). A majority of pharmacies (53%) devoted more than 10 hours per week to PCS, such as immunizations and home delivery. Many pharmacies (47.7%) were willing to devote more than 20 hours per week to PCS with proper reimbursement and were willing to hire additional staff to support these services. Most pharmacies did not use their pharmacy software to target patients for PCS, instead enrolling via staff recommendation or self‐referral. Many pharmacies (48%) reported that greater than 30% of their patient population experienced social‐related barriers including low income and transportation issues. Pharmacies addressed social barriers by offering tailored services towards patient needs.ConclusionsIndependent community pharmacies remain diligent and actively involved in delivering PCS. Many pharmacy patients experience social‐related barriers towards care, and pharmacies are responding by offering tailored services. Further research is needed on the implementation and economic sustainability of PCS in community pharmacy settings.

Call to Action: Addressing Social Determinants of Health in Pharmacy Practice

“…Currently, its implementation has only been studied in the community and outpatient settings. 21,22 In 1 study, 2 pharmacists working in an outpatient behavioral health clinic assessed their patients for SDOH during comprehensive medication management visits. 21 Some of the barriers they encountered included limited time, insufficient staff, and documentation of findings in the electronic health record.…”

“…One survey study analyzed community pharmacists' willingness to adapt their workflow to accommodate screening for SDOH and found that 47.7% of survey respondents were willing to allocate more time and hire additional staff to be able to conduct SDOH screenings, provided they were reimbursed for these services. 22 To overcome the knowledge barrier, pharmacists need training on SDOH and programs available in their communities to mitigate some of the social problems patients share during a visit. Examples of SDOH screening tools are available in Table 2.…”