A novel pharmacy liaison program to address health-related social needs at an urban safety-net hospital

Author:

Borden Caroline G12,Ashe Erin M3,Buitron de la Vega Pablo45,Gast Vi6,Saint-Phard Tracey3,Brody-Fialkin Julianna3,Power Julia7,Wang Na8,Lasser Karen E45

Affiliation:

1. Boston Medical Center , Boston, MA

2. Yale School of Medicine , New Haven, CT , USA

3. Boston Medical Center , Boston, MA , USA

4. Section of General Internal Medicine, Boston Medical Center , Boston, MA

5. Boston University Chobanian & Avedisian School of Medicine , Boston, MA , USA

6. Takeda Pharmaceutical Company , Cambridge, MA , USA

7. Action for Boston Community Development, Inc. , Boston, MA , USA

8. Boston University School of Public Health , Boston, MA , USA

Abstract

Abstract Purpose Patients with unmet health-related social needs (HRSNs) often experience poor health outcomes and have high levels of healthcare utilization. We describe a program where dually trained pharmacy liaison–patient navigators (PL-PNs) screen for and address HRSNs while providing medication management services to patients with high levels of acute care utilization in a Medicaid Accountable Care Organization. We are unaware of prior studies that have described this PL-PN role. Methods We analyzed case management spreadsheets for the 2 PL-PNs who staffed the program to identify the HRSNs that patients faced and the ways PL-PNs addressed them. We administered surveys, including an 8-item client satisfaction questionnaire (CSQ-8), to characterize patient perceptions of the program. Results Initially, 182 patients (86.6% English speaking, 80.2% from a marginalized racial or ethnic group, and 63.2% with a significant medical comorbidity) were enrolled in the program. Non–English-speaking patients were more likely to receive the minimum intervention dose (completion of an HRSN screener). Case management spreadsheet data (available for 160 patients who engaged with the program) indicated that 71% of participants faced at least one HRSN, most often food insecurity (30%), lack of transportation (21%), difficulty paying for utilities (19%), and housing insecurity (19%). Forty-three participants (27%) completed the survey with an average CSQ-8 score of 27.9, indicating high levels of satisfaction with the program. Survey participants reported receiving medication management services, social needs referrals, health-system navigation assistance, and social support. Conclusion Integration of pharmacy medication adherence and patient navigation services is a promising approach to streamline the HRSN screening and referral process at an urban safety-net hospital.

Publisher

Oxford University Press (OUP)

Subject

Health Policy,Pharmacology

Reference32 articles.

1. Standardized screening for health-related social needs in clinical settings: the Accountable Health Communities Screening Tool. NAM Perspect;Billioux,2017

2. Social determinants of health inequalities;Marmot;Lancet,2005

3. Self-restriction of medications due to cost in seniors without prescription coverage: a national survey;Steinman;J Gen Intern Med,2001

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