Resident reflections on serving the underserved

RESIDENTS CORNER

As learners, it can often feel overwhelming to take in the sheer amount of clinical knowledge that comes with being a resident or fellow. While we may learn about social determinants of health in pharmacy school, that knowledge is put to the test in practice as new graduates. In addition to taking in the clinical lessons, we must also learn how to care for and interact with different patient populations, specifically those who may be underserved. 

Here, some of the members of APhA–APPM Pharmacy Residency Standing Committee share key points they have learned throughout their experiences.

Emma Siegel: Ask the key question

Being a PGY1 community/ambulatory resident at a federally qualified health center (FQHC) has taught me many invaluable lessons, one of the most notable being the financial burden of prescription medications. I have been lucky enough to work in a setting with an on-site 340B pharmacy, which has allowed me to connect my patients to the care they need at an affordable price. However, that is not the case for all patients. I think it is incredibly important to take into account cost when making treatment decisions, especially when choosing a medication. 

For example, many uninsured/underinsured patients may not be able to afford a glucagon-like peptide-1 (GLP-1) receptor agonist, which can have significant clinical benefits for patients with Type 2 Diabetes. However, there are many options to consider to help a patient afford these medications, such as patient assistance programs, copay cards, grants, or 340B discount pricing. 

I would encourage all pharmacists to ask their patients before initiating or dispensing a medication: “Is this medication affordable to you?”

Erin Lexner: Understand where the patient may be coming from

Medication affordability in the outpatient setting is notably crucial. Additionally, education on discharge medications and assurance of transportation following a hospital stay is also imperative.

Being a PGY1 pharmacy practice resident in an inpatient setting has allowed me to take care of patients from both urban and more rural settings. Understanding where the patient may be coming from and what resources exist once they leave the hospital is crucial for transitions of care. Being able to advocate for patients as they transition from one care area to another from a pharmacy perspective is huge for providing the best patient care. It is necessary to make sure medication lists are updated in the hospital. It is also important to ensure that the patient receives a discharge medication list that is reflective of what they should be taking, and that prescriptions were sent to our outpatient pharmacy or their local pharmacy so the patient can access them. Patient transportation needs or distance to travel for necessary care should not impact the ability to access their medications in a timely manner after discharge from an inpatient stay. 

While pharmacy residents may practice in various locations, one thing is key: consideration of a patient’s socioeconomic factors is necessary when making important care decisions.

Emma Siegel, PharmD, is a PGY1 pharmacy resident at Five Rivers Health Centers/The University of Cincinnati, in Cincinnati, OH. She enjoys working within ambulatory care and serving underserved patients. Outside of work, she likes doing yoga, reading, and snuggling with her chihuahua “Pip.” Erin Lexner, PharmD, is a PGY1 pharmacy resident at Allegheny General Hospital in Pittsburgh, PA. She enjoys traveling, playing her flute, and reading.