The social determinants of health within Belgian pharmacies: an exploratory qualitative study

Background Pharmacists, embedded in their local communities and in frequent contact with patients, are uniquely positioned to identify and address social determinants of health (SDOH) that influence medication adherence and health outcomes. Understanding how they perceive and respond to these non-medical challenges is essential to improving patient care and reducing health inequities. Methods Semi-structured interviews were conducted to understand pharmacists’ experiences noticing SDOH in their patients during routine practice. Thematic analysis was performed following Braun and Clarke’s guidelines. Results Pharmacists described encountering a range of social needs affecting patients’ medication use and adherence. These included financial hardship, poor health literacy, and limited access to healthcare services. While the nature and visibility of these needs varied by neighbourhood, all participants acknowledged the significant influence of SDOH on patient outcomes. In response, pharmacists reported adapting their services by offering individualized support, such as delayed payment options, use of translation tools, home delivery, and patient education. However, pharmacists also noted challenges in systematically identifying and addressing these needs due to a lack of formal screening tools and structural support. Conclusions Pharmacists are well-positioned to recognize and respond to SDOH, yet their efforts often rely on informal and individualized strategies. Integrating routine screening for SDOH and enhancing collaboration with other healthcare providers could help formalise and strengthen pharmacists' roles in addressing health disparities. Policy support and resource allocation are essential to sustain these efforts and improve equity in healthcare delivery.