Boston Medical Center, Boston, MA.
Yale School of Medicine, New Haven, CT, USA.
Am J Health Syst Pharm. 2023 Aug 4;80(16):1071-1081. doi: 10.1093/ajhp/zxad113.
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.
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.
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.
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.
有未满足的与健康相关的社会需求(HRSN)的患者通常健康状况不佳,并且医疗保健利用率很高。我们描述了一个项目,该项目由经过双重培训的药房联络-患者导航员(PL-PN)在医疗补助管理式医疗组织中为高急性护理利用率的患者提供药物管理服务的同时,对 HRSN 进行筛查和处理。我们不知道之前有研究描述过这种 PL-PN 角色。
我们分析了负责该计划的 2 名 PL-PN 的病例管理电子表格,以确定患者面临的 HRSN 以及 PL-PN 解决这些问题的方式。我们进行了调查,包括 8 项客户满意度问卷(CSQ-8),以描述患者对该计划的看法。
最初,该计划有 182 名患者(86.6%会说英语,80.2%来自边缘化的种族或族裔群体,63.2%有重大医疗合并症)入组。不会说英语的患者更有可能接受最低干预剂量(完成 HRSN 筛查)。病例管理电子表格数据(可用于 160 名参与该计划的患者)显示,71%的参与者至少面临一种 HRSN,最常见的是食品安全问题(30%)、缺乏交通(21%)、难以支付水电费(19%)和住房不安全(19%)。43 名参与者(27%)完成了调查,平均 CSQ-8 得分为 27.9,表明对该计划非常满意。调查参与者报告接受了药物管理服务、社会需求转介、卫生系统导航协助和社会支持。
将药房药物依从性和患者导航服务相结合,是在城市医疗服务网络医院简化 HRSN 筛查和转介流程的一种有前途的方法。