J Am Pharm Assoc (2003). 2023 May-Jun;63(3):799-806.e3. doi: 10.1016/j.japh.2023.01.006. Epub 2023 Jan 11.
Community pharmacies in the United States are beginning to serve as patient care service destinations addressing both clinical and health-related social needs (HRSN). Although there is support for integrating social determinant of health (SDoH) activities into community pharmacy practice, the literature remains sparse on optimal pharmacy roles and practice models.
To assess the feasibility of a community pharmacy HRSN screening and referral program adapted from a community health worker (CHW) model and evaluate participant perceptions and attitudes toward the program.
This feasibility study was conducted from January 2022 to April 2022 at an independent pharmacy in Buffalo, NY. Collaborative relationships were developed with 3 community-based organizations including one experienced in implementing CHW programs. An HRSN screening and referral intervention was developed and implemented applying a CHW practice model. Pharmacy staff screened subjects for social needs and referred to an embedded CHW, who assessed and referred subjects to community resources with as-needed follow-up. Post intervention, subjects completed a survey regarding their program experience. Descriptive statistics were used to report demographics, screening form, and survey responses.
Eighty-six subjects completed screening and 21 (24.4%) an intervention and referral. Most participants utilized Medicaid (57%) and lived within a ZIP Code associated with the lowest estimated quartile for median household income (66%). Eighty-seven social needs were identified among the intervention subjects, with neighborhood and built environment (31%) and economic stability challenges (30%) being the most common SDoH domains. The CHW spent an average of 33 minutes per patient from initial case review through follow-up. All respondents had a positive perception of the program, and the majority agreed that community pharmacies should help patients with their social needs (70%).
This feasibility study demonstrated that embedding a CHW into a community pharmacy setting can successfully address HRSN and that participants have a positive perception toward these activities.
美国的社区药店开始提供患者护理服务，以满足临床和与健康相关的社会需求 (HRSN)。尽管有支持将健康社会决定因素 (SDoH) 活动纳入社区药房实践的意见，但文献仍然缺乏关于最佳药房角色和实践模式的内容。
评估从社区卫生工作者 (CHW) 模式改编的社区药房 HRSN 筛查和转介计划的可行性，并评估参与者对该计划的看法和态度。
这项可行性研究于 2022 年 1 月至 2022 年 4 月在纽约州布法罗的一家独立药店进行。与 3 个社区组织建立了合作关系，其中 1 个组织在实施 CHW 项目方面经验丰富。根据 CHW 实践模式开发并实施了 HRSN 筛查和转介干预措施。药房工作人员对社会需求进行筛查，并转介给一名嵌入式 CHW，后者对患者进行评估，并根据需要将患者转介到社区资源。干预后，患者完成了一项关于他们的项目体验的调查。使用描述性统计数据报告人口统计学、筛查表和调查回应。
86 名参与者完成了筛查，21 名（24.4%）接受了干预和转介。大多数参与者使用医疗补助计划（57%），居住在一个邮政编码中，该邮政编码与估计的中位数家庭收入最低四分位数相关（66%）。在干预组中发现了 87 个社会需求，邻里和建筑环境（31%）以及经济稳定挑战（30%）是最常见的 SDoH 领域。CHW 从最初的病例审查到随访，每位患者平均花费 33 分钟。所有受访者对该计划都有积极的看法，大多数人同意社区药房应该帮助患者解决他们的社会需求（70%）。
这项可行性研究表明，将 CHW 嵌入社区药房环境中可以成功解决 HRSN，并且参与者对这些活动有积极的看法。
