Pharmacists can help manage disparities in access to health care

Pharmacy Times spoke with Orly Vardeny, PharmD, MS, principal investigator at the U.S. Department of Veterans Affairs’ Center for Care Delivery and Outcomes Research, about the role of pharmacists in addressing drug therapy disparities.

Pharmacy hours spoke with Orly Vardeny, PharmD, MS, Principal Investigator at the U.S. Department of Veterans Affairs’ Center for Care Delivery and Outcomes Research, about the role of pharmacists in addressing drug therapy disparities.

Q: What disparities should pharmacists be aware of when it comes to drug therapies?

Orly Vardeny, PharmD, MS: I think it’s important to recognize that drugs approved by the FDA and then recommended in guidelines are not used the same way by everyone. They are not prescribed in the same way for everyone. But we have found, and there have been several analyzes and several studies that have shown, that there are certain groups that do not have access to certain drugs. And this is potentially due to lack of access to healthcare, but it can also be due to inertia in care. I think one example is that women, for example, generally don’t take the recommended statins based on their cardiovascular risk. They are not offered statins, a cholesterol-lowering drug, as often as men might be. Thus, their chances of taking a statin and a dose recommended by the guidelines are lower. Women also stop this medication more frequently and potentially experience more side effects. And so this is an example. Another is in hypertension, when you think about racial and ethnic groups and different controls [levels] may affect blood pressure control treatment. Even awareness of hypertension is different between groups. For example, blood pressure control, per AJCC guidelines, is generally lower, meaning blood pressure is higher for Blacks, Hispanics, or Latinos and for Asians compared to Americans. whites. So this is another example where there are disparities in treatment from several different angles for different groups.

Q: How have these disparities been exacerbated by the COVID-19 pandemic?

Orly Vardeny, PharmD, MS: So I think COVID-19 has taught us that access, and particularly access to health care, has been particularly difficult for people of lower socioeconomic status. [Those] are people who may not be able to access in-person health care. And so what we found was that people put off health care and waited until things got serious or they needed to be hospitalized. And what we found is that people from minority groups are more likely to experience this lack of access to health care and also delayed care.

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