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By: Amber Ray

Health is strongly impacted by the conditions in which people grow, learn, work, and live. Consider, for example, the health implications of trying to exercise in a neighborhood with no sidewalks, being unable to read a prescription drug label, or worrying that your food would run out before your next paycheck. These conditions are often referred to as social determinants of health (SDOH). Some of the most common SDOH assessed in relationship to health outcomes are income, educational attainment, employment status,  and access to food, housing, and transportation. Although non-clinical in nature, there is strong interest in exploring the influence of population-level social conditions on health outcomes and healthcare spending because of the rising cost of healthcare, recent changes in reimbursement policy, and the shift towards value-based care.

There exist many screening tools that identify the presence of unmet social needs, and ample evidence demonstrating how addressing deficits in SDOH can improve overall health outcomes and lower healthcare spending. However, there is less information about what specific role pharmacists can play in tackling this issue. This summer two CMO summer interns, rising high school senior Halle Kahlenberg (bottom) and UNC senior Serena Mahalingam (top), will help make this connection between SDOH and pharmacy. Halle is one of 20 high school students selected to participate in the Young Innovators Program, and Serena is a participant in our college summer internship program. Over the course of eight weeks, the two will assess how SDOH affect medication access, evaluate the evidence on the relationship between SDOH and medication optimization, and determine how we can incorporate SDOH into pharmacy patient care.

Low-income populations often have individuals with unmet social needs who are more likely to have difficulties in managing chronic health conditions, including their medications. Overall, only about 50% of people take their medications as prescribed, but those struggling with housing instability, food insecurity, lack of transportation, unemployment, personal safety issues, and other social needs often find it even harder to be adherent. Those struggling to manage their medications in the face of challenging circumstances need tailored care; however, strategies to address these non-clinical needs by pharmacists are less established.

Only a handful of resources exist detailing how pharmacist can integrate principles of SDOH into patient care, spearheaded by The Center for Healthcare Strategies (CHS). The CHS has worked to bridge this resource gap through their Community Management of Medication Complexity Innovation lab, which offers strategies on how to improve medication management services for people with complex social needs by hosting webinars, reports, blogs, and stakeholder profiles. Our summer interns will build upon this work to help us better understand how pharmacists addressing SDOH can make it easier for patients to properly take their medications.

With the mission to “integrate medication optimization into value-based care delivery and payment models,” The Center for Medication Optimization is excited to explore the relationship between SDOH and value-based care. As providers become increasingly responsible for final health outcomes, understanding the influence that unmet social needs have on the health of communities has become all the more critical.


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