Pharmacist-Led Screening for Health Related Social Needs

Overseen By David Jacobs, PharmD, PhD

Age: 18+

Sex: Any

Trial Phase: Academic

Sponsor: State University of New York at Buffalo

Disqualifiers: Cognitive impairment, Non-English speakers

No Placebo Group All trial participants will receive the active study treatment (no placebo)

Compensation: Varies

Number of Visits: 1

What You Need to Know Before You Apply

What is the purpose of this trial?

This trial explores how pharmacists can assist individuals with health-related social needs (HRSN) after they leave the emergency department. The researchers aim to determine if a pharmacist-led approach, specifically the HRSN Screening and Navigation Intervention, can reduce hospital readmissions and emergency visits by reviewing medications and connecting patients with local support. The trial includes two groups: one receiving this support and a control group that does not. It seeks patients seen at Buffalo General Medical Center who plan to go home after their visit. As an unphased trial, this study offers patients the chance to contribute to innovative healthcare solutions that could enhance post-emergency care.

Will I have to stop taking my current medications?

The trial information does not specify whether you need to stop taking your current medications. It involves a pharmacist-led medication review, so it's best to discuss your current medications with the study team.

What prior data suggests that this pharmacist-led intervention is safe?

Research has shown that addressing social needs related to health can improve patient outcomes. The HRSN Screening and Navigation Intervention connects patients with community resources to meet these needs. This supportive approach is generally safe.

Previous studies indicate that addressing these social needs can improve health without causing harm. In one study, about one-third of these needs were fully met, and another one-third were in progress. This suggests the intervention is both safe and effective in helping patients get the support they need.

The intervention guides patients to resources rather than providing drugs or treatments, so there are no typical drug-related side effects. Overall, this approach is well-tolerated and poses minimal risk to participants. ^{1 2 3 4 5}

Why are researchers excited about this trial?

Researchers are excited about the Pharmacist-Led Screening for Health Related Social Needs because it offers a proactive approach to healthcare by identifying and addressing the social factors affecting health. Unlike traditional treatments that focus solely on medical conditions, this intervention aims to uncover and navigate social needs like housing, food security, and transportation that can impact health outcomes. By integrating pharmacists into the screening process, it leverages their accessibility and expertise to provide personalized, holistic care. This approach has the potential to improve overall health and well-being by tackling the root causes of health disparities.

What evidence suggests that this pharmacist-led intervention is effective for addressing health-related social needs?

Research has shown that checking for social needs related to health can lead to better health outcomes. A review of studies found that addressing these needs in healthcare settings can reduce hospital visits and improve patient health. In this trial, participants in the intervention arm will receive the HRSN Screening and Navigation Intervention. This intervention uses a tool to identify issues like unstable housing or education needs that can affect health. By connecting patients to community resources through this process, emergency room visits decreased in previous studies. Overall, finding and addressing social factors greatly supports better health management and reduces healthcare costs. ^{2 4 6 7 8}

Are You a Good Fit for This Trial?

This trial is for patients at Buffalo General Medical Center's emergency department. It's designed to see if pharmacists can help identify and address non-medical factors that affect health, like housing or food access. Participants must be willing to undergo screening and follow-up.

Inclusion Criteria

Discharge Plan: It is anticipated that the patient will be discharged home

Control Group: Patients in the control group will meet the same inclusion criteria as those in the intervention group, except they will not receive the health-related social needs (HRSN) screening

Status: Patients being seen at Buffalo General Medical Center (BGMC)

Exclusion Criteria

I am mentally capable of understanding and consenting to participate.

I speak English fluently.

Timeline for a Trial Participant

Screening

Participants are screened for eligibility to participate in the trial

1-2 weeks

1 visit (in-person)

Intervention

Pharmacist-led medication review and HRSN screening using the AHC tool, with referrals to community-based organizations

8 months

Ongoing in-person and virtual interactions

Follow-up

Follow-up phone calls within one month to assess contact with referred organizations and conduct patient satisfaction surveys

1 month

Phone calls

Data Analysis

Statistical analysis of healthcare utilization outcomes and patient satisfaction

3 months

What Are the Treatments Tested in This Trial?

Interventions

• HRSN Screening and Navigation Intervention

Trial Overview The study tests a pharmacist-led program where 50 patients get screened for social needs affecting health and are connected with local resources, while another 100 receive standard care without this extra support.

How Is the Trial Designed?

Group I: Intervention Experimental Treatment 1 Intervention

Intervention

Group II: Control Experimental Treatment 1 Intervention

Control

Who Is Running the Clinical Trial?

State University of New York at Buffalo

Lead Sponsor

Trials

279

Recruited

52,600+

National Heart, Lung, and Blood Institute (NHLBI)

Collaborator

Trials

3,987

Recruited

47,860,000+

Published Research Related to This Trial

A study involving 500 patients showed that pharmacist-delivered advice significantly reduced non-adherence to new medications for chronic conditions, with rates of 9% in the intervention group compared to 16% in the control group.

Patients receiving pharmacist support reported fewer medicine-related problems (23% vs. 34%) and had more positive beliefs about their new medication, indicating that this intervention may enhance patient confidence and safety in managing their treatment.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Patient-centred advice is effective in improving adherence to medicines. Clifford, S., Barber, N., Elliott, R., et al.[2022]

A social health screening implemented by pharmacists identified a higher prevalence of unmet social health needs among Medicare patients flagged as higher risk (28.7%) compared to lower-risk patients (12.7%), highlighting the importance of addressing these needs for medication adherence.

Patients who accepted referrals to social health resources showed a significant increase in statin medication adherence (from 62.3% to 74.7%), suggesting that addressing social health needs can positively impact medication adherence without negatively affecting healthcare utilization.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Telephone-based social health screening by pharmacists in the nonadherent Medicare population. Wu, L., Chang, C., Lo, K., et al.[2023]

A nonrandomized controlled trial involving 364 primary care patients aimed to enhance pharmacy care by addressing health-related social needs, but it did not significantly reduce hospital admissions or emergency department visits compared to usual pharmacy care.

Despite the intervention's focus on social needs, the results showed no meaningful difference in healthcare utilization between the enhanced care group and the control group after one year, indicating that simply adding social support in pharmacy settings may not be enough to impact health outcomes.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

A Pharmacy Liaison-Patient Navigation Intervention to Reduce Inpatient and Emergency Department Utilization Among Primary Care Patients in a Medicaid Accountable Care Organization: A Nonrandomized Controlled Trial. Buitron de la Vega, P., Ashe, EM., Xuan, Z., et al.[2023]

A program utilizing pharmacy liaison-patient navigators (PL-PNs) effectively screened and addressed health-related social needs (HRSNs) in 182 patients, revealing that 71% faced issues like food insecurity and lack of transportation, which are linked to poor health outcomes.

Patients reported high satisfaction with the program (average CSQ-8 score of 27.9), indicating that integrating medication management with social support services can improve patient care in a Medicaid Accountable Care Organization setting.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

A novel pharmacy liaison program to address health-related social needs at an urban safety-net hospital. Borden, CG., Ashe, EM., Buitron de la Vega, P., et al.[2023]

A community-based pharmacist program successfully provided preventive health screenings to 702 African American community members, with 72% (508 individuals) referred to clinical and social services, demonstrating effective community-clinical linkages.

This approach shows that community pharmacists can play a crucial role in improving access to healthcare and addressing chronic diseases by connecting patients with necessary services in nontraditional settings.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Pharmacist Involvement in Addressing Public Health Priorities and Community Needs: The Allegheny County Racial and Ethnic Approaches to Community Health (REACH) Project. Elliott, JP., Christian, SN., Doong, K., et al.[2021]

The PHOENIx intervention, which provides structured health and social care assessments in community pharmacies, is being tested in a pilot trial involving 100 people experiencing homelessness in Glasgow and Birmingham, aiming to evaluate its feasibility and effectiveness.

If successful, the study could lead to the establishment of a publicly funded service in community pharmacies, addressing the complex health and social needs of people experiencing homelessness, potentially improving their access to care and overall well-being.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Protocol for a pilot randomised controlled trial to evaluate integrated support from pharmacist independent prescriber and third sector worker for people experiencing homelessness: the PHOENIx community pharmacy study. Paudyal, V., Lowrie, R., Mair, FS., et al.[2023]

Pharmacist-provided education and counseling to Meals on Wheels participants improved medication adherence by 14% over six months, as measured by the Morisky scale.

However, the intervention did not significantly reduce medication-related preventable harm or interactions, indicating that while adherence improved, further research with larger sample sizes is needed to assess overall safety and efficacy.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Promoting Safe Use of Medications: Providing Medication Education to Seniors Receiving Meals on Wheels. Ward, KE., Cohen, LB.[2018]

Citations

1. pmc.ncbi.nlm.nih.gov pmc.ncbi.nlm.nih.gov/articles/PMC12099334/

Health Related Social Needs Screening and Referral ... HRSN are individual-level adverse social determinants of health (SDOH) needs, such as housing instability or low-education level. SDOH, as ...

2. jamanetwork.com jamanetwork.com/journals/jamanetworkopen/fullarticle/2808708

Hospital Screening for Health-Related Social Needs and ... Effectiveness of social needs screening and interventions in clinical settings on utilization, cost, and clinical outcomes: a systematic review.

3. cms.gov cms.gov/priorities/innovation/media/document/ahcm-screeningtool-companion

A Guide to Using the Accountable Health Communities ... In Chapter 1, we introduce the AHC Model and the AHC. HRSN Screening Tool. The AHC Model, a nationwide initiative funded by the Centers for Medicare & ...

4. sciencedirect.com sciencedirect.com/science/article/abs/pii/S0735675723004783

A descriptive study of screening and navigation on health ... Health-related social needs (HRSN) have been associated with increased disease prevalence, worse clinical outcomes, increased Emergency Department (ED) ...

5. publications.aap.org publications.aap.org/pediatrics/article/156/Supplement%201/e2025070739I/203529/Developing-an-Approach-to-Health-Related-Social

Developing an Approach to Health-Related Social Needs ... The WG defined HRSN screening as the process of administering a standardized HRSN screening tool at regular intervals to patient or parent/ ...

6. pubmed.ncbi.nlm.nih.gov pubmed.ncbi.nlm.nih.gov/37778164/

A descriptive study of screening and navigation on health- ... During the study period, one-third of HRSN were successfully resolved with another one-third in-progress. Navigation in high-risk patients was associated ...

7. jamanetwork.com jamanetwork.com/journals/jamanetworkopen/fullarticle/2831879

Health-Related Social Needs Discussions in Primary Care ... Main Outcomes and Measures Characterization of the content and nature of HRSN discussions during clinical encounters within safety-net clinics.

8. medicaid.gov medicaid.gov/health-related-social-needs/downloads/hrsn-coverage-table.pdf

Coverage of Health-Related Social Needs (HRSN) ... Health-related social needs (HRSN) are an individual's unmet, adverse social conditions that contribute to poor health outcomes. These.