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

150 Participants Needed

Trial Summary

What is the purpose of this trial?

The study is a quasi-experimental pilot study conducted at Buffalo General Medical Center (BGMC). It aims to evaluate the feasibility, acceptability, and effectiveness of a pharmacist-led intervention addressing health-related social needs (HRSN) during transitions of care in the emergency department. The intervention involves: 1) pharmacist led medication review, 2) screening patients using the Accountable Health Communities (AHC) HRSN tool, connecting them to local community-based organizations, and 3) conducting follow-up to assess outcomes. The study will recruit 150 patients (50 intervention and 100 control) and assess healthcare utilization metrics, including hospital readmissions and emergency department visits.

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 data supports the effectiveness of the HRSN Screening and Navigation Intervention treatment?

Research shows that when pharmacists screen for social health needs and connect patients to resources, it can improve medication adherence and reduce hospital stays. For example, patients who accepted referrals to social health resources had better adherence to their medications and spent less time in the hospital. ^{1 2 3 4 5}

Is pharmacist-led screening for health-related social needs safe for humans?

The research suggests that pharmacist-led screening for health-related social needs does not have any reported adverse effects on health care use or health plan membership, indicating it is generally safe for humans. ^{2 3 4 5 6}

How is the HRSN Screening and Navigation Intervention treatment different from other treatments for health-related social needs?

The HRSN Screening and Navigation Intervention is unique because it involves pharmacists screening for social health needs and providing navigation services to connect patients with community resources, which is not commonly done in pharmacy settings. This approach focuses on addressing social factors that impact health, such as transportation and finances, rather than just medical treatment. ^{1 2 3 4 7}

Eligibility Criteria

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

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

Treatment Details

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.

Participant Groups

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+

Findings from Research

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]

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 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]

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]

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]

References

1. England 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. [2023]

2. United States pubmed.ncbi.nlm.nih.gov

Telephone-based social health screening by pharmacists in the nonadherent Medicare population. [2023]

3. United States 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. [2023]

4. England pubmed.ncbi.nlm.nih.gov

A novel pharmacy liaison program to address health-related social needs at an urban safety-net hospital. [2023]

5. Germany pubmed.ncbi.nlm.nih.gov

Patient-centred advice is effective in improving adherence to medicines. [2022]

6. United States pubmed.ncbi.nlm.nih.gov

Promoting Safe Use of Medications: Providing Medication Education to Seniors Receiving Meals on Wheels. [2018]

7. United States 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. [2021]