Pharmacists can improve health equity as AMA paper points out
AJ, an 85-year-old man who is presented in a new case and commentary paper in the February 2021 issue of AMA Journal of Ethics, experiences food insecurity, limited access to health care services, poor health literacy, a language barrier, and a lack of social support—all issues that pharmacists routinely see. AJ’s case highlights the role of social determinants of health in a patient’s health outcomes.
Using this patient and his relationship with a pharmacist at a federally qualified health center as an example, Sara Shahdoost Moghadam, PharmD, and Sandra Leal, PharmD, MPH, provide a detailed report about how pharmacists contribute to improving health outcomes and health equity in underserved communities.
“Pharmacists have been addressing [social determinants of health] for years in all populations that experience health disparities, working as vital members of their communities by interacting daily with patients in the community—not only in specialty and community pharmacies, but also in integrated health delivery networks, managed care and community-based settings, health care clinics and physician offices, and hospitals,” wrote Moghadam and Leal.
As just one example, 60% of Americans have a chronic disease like diabetes and hypertension, with minorities and underserved communities disproportionally affected. According to Moghadam and Leal, one potential explanation is the association between these chronic diseases and disparities in nutrition, access to walkable communities, and tobacco marketing.
In a 2010 study published in the American Journal of Managed Care, Jameson and Baty found that 56% of Black individuals who received medication therapy management services from a pharmacist significantly improved their diabetes, compared with 23% of participants in the control group.
“The case illustrated in this article, as well as the evidence provided, emphasizes the role of pharmacists in areas such as chronic disease management and prevention, medication management, health and wellness, and patient advocacy,” wrote Moghadam and Leal.
They go on to say that tackling health disparities requires a team-based, multidisciplinary approach. “Although pharmacists, physicians, and other clinicians could address health disparities separately, it is through a collaborative effort that the health care system will become more efficient in addressing health disparities and meeting the goals set by the federal government to improve the health of all Americans.”
Loren Bonner, senior editor