Pharmacist-led community network approach addressing social needs and adherence (Connect AF)

Area of Science:

• Pharmacy Practice
• Health Services Research
• Social Determinants of Health

Background:

• Social determinants of health (SDOH) significantly impact patient health outcomes and medication adherence.
• Pharmacists are well-positioned to address SDOH, yet evidence on pharmacist-led screening, especially via health-system and community pharmacy collaborations, is limited.

Purpose of the Study:

• To evaluate how community pharmacists address SDOH-related care gaps in atrial fibrillation (AF) patients.
• To assess the role of vertically integrated partnerships in strengthening SDOH interventions through the Connect AF program.

Main Methods:

• The Connect AF program involved a partnership between a health system, community pharmacies (CPESN), a payer, and an industry partner.
• Pharmacists screened 75 AF patients using an adapted SDOH questionnaire covering housing, transportation, mental health, food security, and more.
• Data analysis included descriptive statistics, feasibility, and acceptability surveys.

Main Results:

• Mental health (28%), housing instability (20%), and transportation barriers (20%) were the most common SDOH needs identified.
• While 16% of patients reported needs, 75% expressed uncertainty about accessing referred resources.
• Pharmacists reported high confidence and willingness to continue SDOH support.

Conclusions:

• The Connect AF program demonstrates a scalable model for pharmacists to address SDOH care gaps in AF patients.
• Cross-sector collaboration between health systems, community pharmacies, and payers can enhance patient care coordination.