An In-Clinic Food Pharmacy Addresses Very Low Food Security

HOW

For a month-long pilot, 3 physicians screened adult, English-speaking patients using 15 questions from the Hunger Vital Signs and the Protocol for Responding to and Assessing a Patient’s Assets, Risks, and Experiences (PRAPARE) tool. Patients were given a laminated screening form at checkin. The rooming nurse collected the form and entered the responses into the patient’s electronic medical record (EMR); the physician reviewed the patient’s responses before entering the exam room.

If patients reported experiencing food insecurity, clinicians offered a referral to the in-clinic food pharmacy for a 2-day emergency supply of food (Supplemental Figure 1), as well as a referral to the in-house social worker to discuss longer-term solutions to food insecurity (including referrals to Loaves and Fishes pantries). Physicians designated a food pharmacy prescription as a Miscellaneous Medication. At check-out, patients would exchange the paper prescription for a bag of food from the food pharmacy. Recognizing the patient is likely not the lone person in the household, additional resources were provided that would address the need of others in their household.

After the pilot, we expanded screening to include all adult English- and Spanish-speaking patients at yearly and new patient visits. All clinicians were eligible to refer patients to the food pharmacy. Patient education was developed about why these screening questions are being implemented in the clinical setting and encouraging conversation with their clinicians.