(1283) The Roles of Pharmacists in Advancing Health Equity for Persons with Chronic Diseases

Objectives: People from racial and ethnic minority groups – a term that encompasses African American or Black, Hispanic, Asian, Native Hawaiian, Pacific Islander, American Indian or Alaska Native, and other non-White persons – have disproportionately higher rates of chronic diseases than White persons. Health disparities among racial and minority groups are largely explained by inequalities in the social, economic, and environmental factors that impact and influence health. These inequalities can include differences in access to health care and quality of care.

Pharmacists are trusted healthcare professionals who typically have a strong understanding of local social, economic, and cultural dynamics. Pharmacists who practice in community-based settings are typically more accessible to patients than other clinicians, well-positioning them to offer services that can advance health equity. Research suggests that approximately 90% of the US population lives within five miles of a pharmacy and visits their pharmacist more frequently than primary care clinicians. This study aims to explore how pharmacists can address health disparities and advance health equity for patients with chronic diseases.

Methods: Researchers engaged 13 subject matter experts (SMEs) in pharmacy policy and practice to identify pharmacist-led initiatives or programs addressing health disparities in chronic diseases. Based on existing literature and suggestions from the SMEs, researchers selected six programs to research further. Selected programs of various sizes, practice settings, and geographic regions utilized pharmacists in collaboration with other healthcare professionals to provide chronic disease prevention, treatment, and management services. Researchers conducted semi-structured interviews with representatives from selected programs. Additionally, three national experts were interviewed to provide insights on pharmacist-led initiatives, national trends, and policies that either support or hinder such initiatives in addressing health disparities. Program and national expert interviews, which lasted one hour each, were conducted via videoconference, and qualitative data were analyzed using NVivo software through an open coding process.

Results: The interviews revealed three key themes highlighting the role of pharmacists in advancing health equity for patients with chronic diseases. First, community-based pharmacists can contribute to health equity by providing tailored, culturally, and linguistically appropriate care. Interviewees noted that pharmacists, with their close geographic proximity to patients, have a unique advantage in understanding patient needs and addressing medical mistrust through established community relationships. Second, there are opportunities to leverage resources available to pharmacists by collaborating with other healthcare team members, including pharmacy technicians and community health workers. Through effective coordination with community partners, pharmacists can develop tailored programs and initiatives that address community needs and effectively address health disparities. Finally, training and resources to support pharmacists in enhancing equity and overcoming barriers is essential. Interviewees noted the role of grants in developing programs and initiatives that address health disparities. However, the application process is time-consuming, requiring staff time for searching, applying, and managing grant-related obligations. Additionally, the lack of universal pharmacist provider status across all payers hinders pharmacists' ability to receive reimbursement for providing services, including those focused on addressing health disparities.

Conclusions: Community-based pharmacists are well-positioned to address health disparities and ultimately advance health equity for persons with chronic disease. They can develop an understanding of their community’s social determinants of health-related needs by building partnerships with community-based organizations and other members of the care team such as community health workers to help address medical mistrust. However, pharmacists may need additional support, education, and training to effectively advance such efforts. Pharmacy researchers can support the implementation and evaluation of pharmacy-based initiatives to advance health equity.