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Defining the role of pharmacists in food pharmacy
Background:
Hypertension and diabetes disproportionately impact Black/African American and Latinx communities in the United States. These disparities are driven by structural factors such as food insecurity and limited health care access. Clinic-based Food Pharmacy (FP) programs aim to reduce nutrition insecurity and support chronic disease management, but the optimal role of clinical pharmacists within these programs remains unclear.
Objectives:
This retrospective exploratory cohort study evaluated 5 models of pharmacist involvement in San Francisco Health Network FPs and examined their relationship with patient new engagement with the pharmacist. Secondary aims assessed the effect of FP on blood pressure (BP) and hemoglobin A1c (A1c).
Methods:
Patients newly enrolled or re-engaged in FP between July 1, 2022, and July 1, 2024, were grouped by model: Individual, Coordinated Care, Community, Referral, or No Involvement. Patient data and clinical measures were extracted from electronic health records. Statistical comparisons used analysis of variance, t-tests, and chi-square tests.
Results:
Among 178 participants, pharmacist engagement varied significantly across models (P < 0.001), with the Individual model showing the highest visit rate (58.3%) and Community and No Involvement the lowest (6.3%). Despite minimal new engagement, the Community model showed the largest A1c reduction (-1.0%). No significant differences in BP or A1c change were observed across models.
Conclusion:
Despite being underpowered, this study demonstrates the feasibility and variability of pharmacist integration within real-world FP programs. The individual model showed higher patient engagement with pharmacists but was not clearly associated with improved clinical outcomes. Findings suggest that baseline disease burden and patient access to food may influence outcomes more than pharmacist involvement alone. These results provide preliminary estimates to inform future prospective studies and highlight the importance of standardized recruitment, clearer pharmacist roles, and improved accessibility to optimize program impact.
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