A research poster that was presented at the Academy of Managed Care Pharmacy (AMCP) Nexus takes a closer look at social determinants of health (SDOH), which are economic, environmental and social factors that can impact the wellbeing of both individuals and groups. These determinants are grouped into five domains: economic stability; education access and quality; health care access and quality; neighborhood and built environment; and social and community context. Environmental conditions, such as air quality, can impact lung health, and SDOH metrics can be a key factor when treating patients with chronic lung diseases, such as asthma.  

This study explores how researchers can use publicly available data to create measures of SDOH related to neighborhood and built environment, considering both air quality index and pharmacy claims data. Researchers identified metrics associated with antimicrobial resistance (AMR) within a commercially insured population.  

The study identified that SDOH measures can be used to predict AMR and pre-emptively identify patients that may not have their condition under control. This enables providers to target interventions to improve maintenance medication adherence, encourage patients to limit outdoor activity during adverse air conditions and to plan outdoor activities when pollution levels are typically at their lowest.

I (Alex Cook, part of Prime’s newsroom team) connected with Kristin Brown-Gentry, MS, director of medical analytics at Prime and lead author on this study, to take a closer look at the research.

Alex Cook: As you know, AMCP’s mission is “to improve patient health by ensuring access to high-quality, cost-effective medications and other therapies,” but your study looks at something much more foundational than that. What inspired you and the team that design this study?
Kristin Brown-Gentry: Alex, great question! My team works closely with our clinical teams to create predictive models to pre-emptively identify patients at risk of adverse events, specifically medication nonadherence and opioid abuse and misuse. One drug class we focus on is asthma and COPD medications. With our pharmacy benefit management (PBM) customers, we typically do not have access to medical claims data; therefore, we work to identify areas in which pharmacy claims data can be enriched. Knowing that SDOH can impact a person’s health and health outcomes, we initially wanted to bring in survey data to assess SDOH metrics; however, we quickly determined this was not feasible as these surveys are expensive to facilitate and do not typically yield substantial results. Therefore, we wanted to identify proxies for SDOH metrics that were associated with clinical outcomes related to asthma medications. So, we were inspired by the possibility of enriching pharmacy claims data so we can provide meaningful insights to our clients, clinical teams and patients we serve.

One of the key findings of this study was that individuals should consider limiting activity when air quality is poor. What were some of the more reliable sources that you found in your research that patients can use to keep an eye on these factors?
The U.S. Environmental Protection Agency’s AirNow website (AirNow.gov) is a great resource individuals can use to get accurate information about the current and future air quality in their community. Users can input their ZIP code and get information on the current air quality index and the primary pollutant within their region, as well as receive recommendations if reducing outdoor activities is warranted. 

How can providers use SDOH more effectively in their practice when treating patients with asthma? 
Providers can use SDOH to create personalized care plans to help improve health outcomes for the patients they serve. 

SDOH research continues to evolve, but how would you like to see it advance in the future?
We have learned a lot in recent years about the predictive power of utilizing publicly available SDOH data sources, and we’ve already been able to incorporate a lot of these findings into our predictive models. In the future, I would be excited by further innovations and program interventions designed to incorporate more of our SDOH learnings. Further research could be focused on the effect of interventions at alleviating barriers introduced by SDOH and reducing health disparities.

Check out more AMCP Nexus 2024 in focus content in the Prime newsroom. For more information on this research, check out the research poster.