SDOH
Loren Bonner
A patient’s environmental conditions will determine how they are able to adhere to a pharmacist’s recommendations. This is the concept of social determinants of health (SDOH). These social and environmental factors are playing a much greater role in health care because of how they affect a patient’s ability to achieve and maintain health and wellness. In the community pharmacy setting, SDOH are the difference between a patient being able or not being able to access or manage their medications.
“Maybe that person doesn’t even have transportation to go to the pharmacy,” said Sharmon Osae, PharmD, a clinical assistant professor at the University of Georgia College of Pharmacy.
As pharmacists lean into understanding SDOH for patients, there are tools available to help them stay informed and educated.
The Pharmacy Quality Alliance (PQA) issued a new resource guide to help pharmacists navigate certain SDOH that might come up when a patient visits the pharmacy.
“We created it to fill a gap in the resources available,” said Richard Schmitz, chief engagement officer at PQA. “We hope it provides health care professionals with ideas of services they can implement in different settings and communities.”
The PQA guide is the first to document pharmacist and pharmacy centered SDOH services, and aims to provide pharmacists with ideas of services they can put in place.
Osae said she originally consulted HHS’s Healthy People 2030 to get most of her information about SDOH.
“It may not be pharmacist-centric, but it can provide a great, basic understanding of SDOH,” she said.
Accessing and using medications properly
Medication cost, literacy, transportation and other SDOH issues impact a patient’s ability to access medications and to use them safely and effectively.
“When you think about measuring medication adherence and other patient outcomes, addressing [social determinants of health] can help achieve better performance,” said Schmitz.
Pharmacists are well-positioned to screen patients for SDOH and refer them to services. But identifying SDOH issues through screening is just the first step in helping patients.
“Many patients need extensive and ongoing support or services that are beyond what pharmacists or other care providers can offer. The ability to refer patients to community services is critical. The guide has great examples and resources for referrals,” said Schmitz.
Getting started
Osae said addressing patients’ SDOH can feel overwhelming for pharmacists, but she urges them not to get intimidated or discouraged.
Sometimes, for example, it’s as simple as reframing the conversation with a patient beginning with asking: “Is it okay if we spend a few minutes talking about your experiences and the priorities in your life outside the clinic that might be affecting your health?”
Often, APhA or ASHP offer continuing education or webinars on SDOH topics. “Find out what your professional organization is offering,” Osae said.
“My call to arms is for all of pharmacy to intertwine [SDOH] throughout the entire pharmacy career continuum,” said Osae.
This includes education for pharmacy technicians, pharmaceutical scientists, as well as those pursuing PharmD training and residency. ■