Q&A: New PQA Resource Highlights 40 Projects Targeting Social Determinants of Health

As health care leaders look beyond the prescription pad to improve patient outcomes, the Pharmacy Quality Alliance (PQA) is spotlighting how social factors shape whether medications work as intended. Its Social Determinants of Health (SDOH) Resource Guide profiles 40 projects across settings such as community pharmacies and health plans, detailing which health-related social needs were targeted, how interventions were designed, and what results they achieved. One theme rose to the top: collaborative community partnerships are central to success.

PQA’s new SDOH Resource Companion Guide digs into those partnerships. Based on interviews with participating organizations, it outlines two sets of skills that drive effective collaboration: strategic approaches like assembling a diverse team and defining success upfront, and supporting attributes such as mission alignment, adaptability, and strong communication. Pharmacists, embedded in communities and often the first point of contact for patients, play a pivotal role—especially in initiatives addressing food insecurity and other pressing social needs.

Tammy Malm, PharmD, MPH, BCPS, director of education at PQA, discusses the third edition of the guide.

Drug Topics®: PQA has published several editions of an SDOH Resource Guide. What does that guide cover?

Tammy Malm, PharmD, MPH, BCPS: The PQA SDOH Resource Guide has 3 additions, the most recent of which details 40 projects where groups tackled 1 or more health-related social needs. The guide groups the projects by setting, like community pharmacy or health plan, and it describes the SDOH barrier that the group targeted, as well as their methods and outcomes for the project. It's important to note that PQA's work focuses on SDOH because addressing these factors is important to advancing medication use quality and ultimately helping individuals achieve good outcomes.

Drug Topics: Just last month, PQA published a companion to that guide focused on partnerships to address SDOH barriers. What was the impetus behind this project?

Malm: We are excited to publish the SDOH Resource Companion Guide, which is, as its name suggests, a companion to the SDOH Resource Guide. At the very beginning of the resource guide, there's a section that highlights the common themes amongst these projects, and the number one theme was collaborative community partnerships. We've collected feedback after publication of each version of the resource guide, and people are often asking the same thing: Can you tell me more about these partnerships? We developed the companion guide, which describes key attributes of the groups that implemented SDOH interventions with a partner, highlighting the partnerships and their own companion guide, especially the skills needed to be successful. It felt like the best way to talk about the importance of collaboration amongst these groups.

Drug Topics: What did PQA find to be the key characteristics of effective partnerships between pharmacies, other care providers, and community organizations?

Malm: Through many interviews with these partners, we were able to group the characteristics into 2 buckets: strategic approaches and supporting attributes. The strategic approaches are some of those hard skills, or those tangible checkbox-type skills that help guide partnerships towards success. Examples detailed in our companion guide include assembling a diverse team and defining what success looks like up front. The supporting attributes are more of those soft skills, those things that are harder to measure but equally important. For example, groups being aligned on the mission and being able to adapt as the project progresses are highlighted here. There are 10 skills in total discussed in the companion guide, but it should be noted that there are a dozen other skills that could be added to this list, and it still would not cover all the skills that these groups had. Furthermore, although having all these skills within a partnership is a great way to get started, it is not necessarily the only path to achieve success. These were the skills that our partners highlighted the most often and felt were critically important to their SDOH initiatives.

Drug Topics: What is an SDOH champion, and how can they keep SDOH initiatives from becoming secondary to clinical tasks?

Malm: This is a great question, and what the guide suggests is that your SDOH champion does not need to step away from clinical tasks or make clinical tasks secondary, but rather, the group needs to identify a champion that can hold the mission steady while navigating challenges and resistance. Being able to clearly communicate the group's vision for the project while discussing it with leadership and stakeholders will allow the project to move forward. An SDOH champion needs to be a good communicator that is persistent and passionate about the health-related social need that is being addressed. They do not need to put their clinical work second but rather stay focused on the path forward and trust that their diverse and skilled team can carry the project down that path.

Drug Topics: The companion guide mentions food and nutrition security as one of the primary barriers to medication outcomes. How can a pharmacy team integrate food security screenings into their workflow?

Malm: We did happen to interview a few partnerships that focused on the SDOH barrier of food security, and I think this is because of the nature of this particular barrier. It's one where a partnership is necessary to even get started. Pharmacies and providers may have a list of resources in the community that they could refer a patient to, but these particular groups showed that they could do more and achieve better patient outcomes when they partnered with a food organization. Furthermore, when discussing SDOH, barriers, food, and medications tend to always compete for a person's financial resources. So on any given day, a patient will look at the money that they have and decide whether that money will go towards food or towards medications, and the fact of the matter is that most people need both food and medications, but that isn't always possible. So by partnering with the food organization, pharmacists and providers can find ways to get patients access to food so they don't have to decide between these 2 extremely important health needs when integrating food security screenings into a workflow. That's actually what pharmacists have been doing for decades. So, how pharmacists interact with and screen patients, whether it be formally or informally, has occurred at the pharmacy counter for a whole list of disease states. Of course, formalizing the food insecurity survey for the pharmacist or the pharmacy technician does allow for a more detailed understanding of a patient's barriers to care and could be added to a variety of steps in the pharmacy workflow.

Drug Topics: The PQA guide suggests identifying 1 key SDOH barrier rather than addressing everything at once. How can pharmacists determine which barrier is the most significant for their population?

Malm: Pharmacists are embedded in the community and are important members of the team, but I need to underscore that pharmacists are not alone in this. It is so important that pharmacists are brought on board as partners in tackling any health-related social need, as they have spent years building trust within their community and are often the first line of care when patients have a health concern. Whether it is the pharmacist or the partner, it is important to use local health data, claims data, or community assessments to identify the most pressing and solvable needs. With a data-informed decision about which health-related social need to tackle, it will be easier to gain buy-in and secure human and financial resources for that project.

Drug Topics: How can pharmacists ensure that their SDOH initiatives are grounded in human relationships rather than just digital referrals?

Malm: Across the companion guide, there is enormous variation in how SDOH programs are developed and implemented, and that is driven by the local nature of SDOH barriers, as well as the unique resources that are available to address those barriers. So effective, SDOH work is fluid. It is nimble. It is responsive to the evolving environment and community needs. This is the bread and butter of what a pharmacist does on a daily basis by simply being embedded in the community, talking to patients, and being open and sensitive to their needs and barriers. The pharmacist is one of the best people to ensure that an SDOH initiative is grounded in human connection.

Drug Topics: Is there anything else you would like to add?

Malm: The guide emphasizes the importance of partnerships, whether it be between a community-based organization and a food pantry, a pharmacist and a provider, or a national health plan and a nonprofit; the partnership strengthens all initiatives that are highlighted in this companion guide. Additionally, it is important to find groups within the community that have established trust with community members, like the pharmacist, or the food pantry, or a community-based organization, while also finding groups that have the financial and human resources to get the project off the ground. We're really excited to have this companion guide published and hope that it will be a useful tool for any groups looking to form a partnership for SDOH-related work in the future. Last, we have to give a big thank you to each and every group that agreed to be interviewed for this companion guide. Their passion and enthusiasm for their respective projects is palpable, and I'm very fortunate to have a chance to discuss their work with them. So, thank you to these groups.