Category: Professional Posters
Purpose: The role of pharmacists in the outpatient setting have expanded beyond dispensing medications and medication therapy management. Pharmacists are now involved in many aspects of patient care, including assessing for social and economic barriers. A growing area the pharmacist can make an impact is incorporating pharmacy-based public health services in the clinical settings. Objectives from this project included: 1) Pilot pharmacist-initiated screening program on food insecurities in the outpatient setting; 2) Compare the patterns of health outcomes/behaviors among Veterans who are food secure vs. insecure; 3) Compare patterns of health services utilization among Veterans who are food secure vs. insecure.
Methods: This pilot project was conducted from January 2018 thru March 2018 at the Veterans Affairs Medical Center's outpatient clinics. Ideas for this project came from a previously completed project on screening for food insecurity in the Veterans Administration clinics for the homeless. Using one validated screening question, we surveyed Veteran's patients in three pharmacists-managed outpatient clinics (congestive heart failure, diabetes, and anticoagulation) for food insecurity. The pharmacist used a paper tracking tool to record the patient encounter. Data collected includes whether the patient was food-secured or food-insecured, blood pressure and glycemic control, and emergency room visits. Patient demographics information (age, sex, and ethnicity), body mass index, co-morbidities, and a social worker referral was also documented.
Results: The pharmacist surveyed a total of 81 patients from January 2018 thru March 2018 at the Veterans Affairs Medical Center's outpatient clinics. The mean age of the patient was 66 years old, with 95% being males. Of the 81 patients, 80% was diagnosed with hypertension, followed by type II diabetes mellitus (58%), and congestive heart failure (38%). Overall, 27 (33%) flagged positive for food insecurity within the last 12 months. Of those 27 flagged positive, 17 patients wanted a referral to the social worker for additional help such as identification of alternative food sources (soup kitchens or food pantries). Additionally, of those flagged positive for food insecurity, 47% had uncontrolled hypertension, 30% had hemoglobin A1c above 9, and 15% had an emergency room visit due to hypertensive crisis or hypoglycemia adverse drug reactions.
Conclusion: No previous project involved the pharmacist's assessment for food insecurity was conducted at the Veterans Affairs Medical Center's outpatient clinics. Incorporating food insecurity screening was well-received by both providers and patients. Results of this pilot project support that pharmacists may have a unique role in addressing food insecurities and contributing to closing the gap in health outcomes faced by the Veteran's population.