Readiness and willingness of Malaysian community pharmacists in providing vaccination services

Community pharmacists' knowledge, beliefs, and perceived barriers toward vaccination services at community pharmacies: A cross-sectional study from Saudi Arabia

Community pharmacists were recently authorized to provide vaccination services in Saudi Arabia. However, the implementation is still limited. Consequently, this study aimed to assess the knowledge, beliefs, and views of community pharmacists in the Qassim region regarding vaccines and vaccination services and to identify the barriers to providing such services. A total of 170 community pharmacists participated in the study (response rate = 73.91%). The mean overall knowledge of vaccines and vaccination was 10.25 ± 1.35 out of a maximum score of 14. The majority stated that vaccines are rigorously tested for their safety (92.94%), go through a stringent approval process to ensure their quality and efficacy (93.53%), and vaccines play a key role in preventing and controlling infectious disease outbreaks (97.06%). However, only 48.82% were aware that community pharmacists are legally authorized to provide adult vaccination services. Few participants were also aware of the dosing of the varicella vaccine (14.12%) and indications of the herpes zoster vaccine (21.18%). The overall mean score on beliefs/views was 31.91 ± 5.53 out of a maximum of 40, indicating positive beliefs/views regarding vaccination services. The study identified many barriers to implementing vaccination services. These included lack of support staff and technicians in community pharmacies (79.41%), lack of requirements and equipment to provide the service (74.11%), the service will add extra workload (72.94%), and lack of formal certification in pharmacy-based immunization delivery (66.48%). Consequently, a holistic strategy is required to improve pharmacists' clinical knowledge of vaccines and to address the barriers to the implementation of vaccination services at community pharmacies.

Factors influencing the uptake of public health interventions delivery by community pharmacists: A systematic review of global evidence

BACKGROUND

Community pharmacies are the first point of contact for most people seeking treatment for minor illnesses globally. In recent years, the role of community pharmacists has evolved, and they play a significant role in the delivery of public health interventions (PHIs) aimed at health promotion and prevention such as smoking cessation services, weight management services, HIV prevention, and vaccination. This review aims to explore the evidence on the factors that influence community pharmacists to take up the role of delivery of such interventions.

METHODS

Three electronic databases namely, Embase (1947-December 2023), Medline (1975-December 2023), and Scopus (1823-December 2023) were searched for relevant literature from the inception of the database to December 2023. Reference lists of included articles were also searched for relevant articles. A total of 22 articles were included in the review based on our inclusion and exclusion criteria. The data were analyzed and synthesized using a thematic approach to identify the factors that influence the community pharmacist's decision to take up the role of PHI delivery. Reporting of the findings was done according to the PRISMA checklist.

FINDINGS

The search identified 10,927 articles of which 22 were included in the review. The main factors that drive the delivery of PHIs by community pharmacists were identified as; training and continuous education, remuneration and collaboration with other healthcare professionals. Other factors included structural and workflow adjustments and support from the government and regulatory bodies.

CONCLUSIONS

Evidence from this review indicates that the decision to expand the scope of practice of community pharmacists is influenced by various factors. Incorporating these factors into the design of policies and public health programs is critical for the successful integration of community pharmacists in the delivery of broader public health to meet the rising demand for health care across health systems.

Pharmacists' Willingness to Offer Vaccination Services: A Systematic Review and Meta-Analysis

Pharmacy-based vaccination (PBV) services increase coverage and enhance access to lifesaving vaccines. This systematic review assessed the proportion of pharmacists willing to offer PBV services. PubMed/MEDLINE, CINAHL, EMBASE and Scopus electronic databases were searched from inception to identify relevant literature. Google scholar and other sources of grey literature was also searched. The literature findings were synthesized narratively, and via a random-effects meta-analysis. Risk of bias was evaluated using nine quality assessment criteria adapted from the Joanna Briggs Institute checklist for prevalence studies. The review protocol is registered on PROSPERO (REF: CRD42021293692). In total, 967 articles were identified from the literature search. Of this, 34 articles from 19 countries across 5 WHO regions were included in the review. No article from the Western Pacific WHO region was identified. Most of the included studies (n = 21, 61.8%) showed an overall low risk of bias. None showed a high risk of bias. Pooled willingness for PBV services was 69.45% (95% CI: 61.58-76.33; n total pharmacists = 8877), indicating that most pharmacists were willing to offer the service, although nearly a third were not. Pharmacists' willingness was highest in the Americas (71.49%, 95% CI: 53.32-84.63, n pharmacists = 3842) and lowest in the African region (58.71%, 95% CI: 45.86-70.46, n pharmacists = 1080) although the between-group difference was not statistically significant across the WHO regions (Q = 3.01, df = 4, p < 0.5567). Meta-regression showed no evidence (R2 = 0%, p = 0.9871) of the moderating effect of the type of vaccine assessed, PBV service availability, sampling technique and the study risk of bias. These findings show that most pharmacists are willing to offer PBV services; however, strategies that will enhance greater involvement in service provision are needed.

Knowledge and attitudes of community pharmacists on vaccination, barriers and willingness to implement community pharmacy-based vaccination services in Ethiopia

This study aimed to evaluate the knowledge and attitudes of community pharmacists (CPs) on vaccination and assess the barriers and willingness to implement community pharmacy-based vaccination services (CPBVS) in Ethiopia. An online cross-sectional study was conducted on 423 CPs in Ethiopia, and questionnaires were distributed to CPs through the Ethiopian Pharmaceutical Association telegram group and e-mail invitations. Data were analyzed using the Statistical Package for Social Sciences (SPSS) version 27. Most CPs (92%) had good knowledge of vaccination, and 43.5% strongly agreed that the population's immunization rates would rise if CPs were authorized to provide vaccinations. The overall mean attitude score (±SD) toward vaccination was 35.95 (±4.11) out of a total score of 45, with 187 (44.2%) scoring below the mean. The most common barriers were lack of authorization (94.1%), costs and time associated with professional development and training (71.4%), time requirements for professional development (70%), and insufficient staff or resources for implementation (70%). Two hundred thirty CPs (54.4%) expressed a willingness to implement CPBVS. Educational qualifications were significantly associated with knowledge of CPs regarding vaccination. Those with inadequate knowledge had about 2.5 times (AOR = 2.51, 95% CI: 1.19, 5.31, p = .016) a poorer attitude toward vaccination services compared with those with adequate knowledge. Those study participants who had a good attitude toward vaccination services were nearly seven (AOR = 6.80, 95% CI: 4.36-10.59, p = .0001) times more willing to provide CPBVS when compared with their counterparts. Implementing CPBVS in Ethiopia requires overcoming barriers and providing professional development opportunities.