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Ezeala OM, McCormick NP, Meininger CL, Durham SH, Hastings TJ, Westrick SC. Factors Associated with the Implementation of Pediatric Immunization Services: A Survey of Community Pharmacies. Vaccines (Basel) 2024; 12:93. [PMID: 38250906 PMCID: PMC10818495 DOI: 10.3390/vaccines12010093] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/06/2023] [Revised: 01/13/2024] [Accepted: 01/15/2024] [Indexed: 01/23/2024] Open
Abstract
Pharmacists are well-positioned to help increase pediatric immunization rates. This study assessed the types of pediatric vaccines offered in community pharmacies, compared participant/pharmacy characteristics and participants' perceptions of barriers and pharmacists' role in providing pediatric immunizations between pharmacy-based providers and non-providers, and assessed factors associated with pharmacy-based pediatric immunization provision. A cross-sectional survey was sent to Alabama community pharmacies from February to April 2023, of which 240 responded (20.5% response rate). Measures included whether they offered childhood vaccines in 2022 and the types of vaccines administered, participants' perceptions of pharmacists' role in pediatric immunization, and perceived barriers to providing pharmacy-based pediatric immunizations. Roughly half of pharmacies (50.8%) provided pediatric immunization services with influenza vaccines (91.0%) the most commonly provided vaccines and poliovirus-inactivated vaccines (4.9%) the least. Pharmacies providing pediatric immunization services significantly differed from non-providers. That is, the majority of providers practiced within a grocery or retail store; they were younger and practiced in a pharmacy with higher average daily prescription volume and a higher average pharmacy practice full-time equivalent; and they perceived lower implementation logistics barriers and a lower role of pharmacists regarding pediatric immunization. Multivariable logistic regression analysis indicated that implementation logistics is significantly associated with pharmacies offering pediatric immunization services after controlling for pharmacy/participant characteristics (p = 0.01). Therefore, ameliorating implementation logistics barriers should be considered when devising strategies to promote pediatric immunization services in community pharmacies.
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Affiliation(s)
- Oluchukwu M. Ezeala
- Department of Health Outcomes Research and Policy, Harrison College of Pharmacy, Auburn University, Auburn, AL 36849, USA (N.P.M.); (C.L.M.)
| | - Nicholas P. McCormick
- Department of Health Outcomes Research and Policy, Harrison College of Pharmacy, Auburn University, Auburn, AL 36849, USA (N.P.M.); (C.L.M.)
| | - Christopher L. Meininger
- Department of Health Outcomes Research and Policy, Harrison College of Pharmacy, Auburn University, Auburn, AL 36849, USA (N.P.M.); (C.L.M.)
| | - Spencer H. Durham
- Department of Pharmacy Practice, Harrison College of Pharmacy, Auburn University, Auburn, AL 36849, USA;
| | - Tessa J. Hastings
- Department of Clinical Pharmacy and Outcomes Sciences, College of Pharmacy, University of South Carolina, Columbia, SC 29208, USA;
| | - Salisa C. Westrick
- Department of Health Outcomes Research and Policy, Harrison College of Pharmacy, Auburn University, Auburn, AL 36849, USA (N.P.M.); (C.L.M.)
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Sin CMH, Huynh C, Dahmash D, Maidment ID. Factors influencing the implementation of clinical pharmacy services on paediatric patient care in hospital settings. Eur J Hosp Pharm 2021; 29:180-186. [PMID: 33472818 DOI: 10.1136/ejhpharm-2020-002520] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/10/2020] [Revised: 12/02/2020] [Accepted: 01/04/2021] [Indexed: 11/04/2022] Open
Abstract
OBJECTIVES This systematic review (SR) was undertaken to identify and summarise any factors which influence the implementation of paediatric clinical pharmacy service (CPS) from service users' perspectives in hospital settings. METHODS Literature search from EMBASE, MEDLINE, Web of Science (Core Collection), Cochrane Library, Scopus and CINAHL databases were performed in order to identify any relevant peer-reviewed quantitative and qualitative studies from inception until October 2019 by following the inclusion criteria. Boolean search operators were used which consisted of service, patient subgroup and attribute domains. Studies were screened independently and included studies were quality assessed using Mixed Methods Appraisal Tool. The study was reported against the 'Enhancing Transparency in Reporting the Synthesis of Qualitative Research' statement. RESULTS 4199 citations were screened by title and abstract and 6 of 32 full publications screened were included. There were two studies that were graded as 'high' in quality, with four graded as 'moderate'. The analysis has led to the identification of seven factors categorised in five predetermined overarching themes. These were: other healthcare professionals' attitudes and acceptance; availability of clinical pharmacist on ward or outpatient settings; using drug-related knowledge to perform clinical activities; resources for service provision and coverage; involvement in a multidisciplinary team; training in the highly specialised areas and development of communication skills. CONCLUSION Evidence for paediatric CPS was sparse in comparison to a similar SR conducted in the adult population. An extensive knowledge gap within this area of practice has therefore been identified. Nevertheless, majority of the factors identified were viewed as facilitators which enabled a successful implementation of CPS in paediatrics. Further research is needed to identify more factors and exploration of these would be necessary in order to provide a strong foundation for strategic planning for paediatric CPS implementation and development.
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Affiliation(s)
- Conor Ming-Ho Sin
- Aston Pharmacy School, College of Health and Life Sciences, Aston University, Birmingham, UK .,Pharmacy Department, United Christian Hospital, Kwun Tong, Kowloon, Hong Kong
| | - Chi Huynh
- Aston Pharmacy School, College of Health and Life Sciences, Aston University, Birmingham, UK
| | - Dania Dahmash
- Aston Pharmacy School, College of Health and Life Sciences, Aston University, Birmingham, UK
| | - Ian D Maidment
- Aston Pharmacy School, College of Health and Life Sciences, Aston University, Birmingham, UK
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3
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Dudley MZ, Taitel MS, Smith-Ray R, Singh T, Limaye RJ, Salmon DA. Effect of educational and financial incentive-based interventions on immunization attitudes, beliefs, intentions and receipt among close contacts of pregnant women. Vaccine 2021; 39:961-967. [PMID: 33423837 DOI: 10.1016/j.vaccine.2020.12.067] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/20/2020] [Revised: 12/17/2020] [Accepted: 12/23/2020] [Indexed: 10/22/2022]
Abstract
INTRODUCTION Cocooning, the vaccination of close contacts of a newborn, is a strategy to limit the risk of pertussis and influenza infection among vulnerable infants. METHODS Pregnant women in Colorado and Georgia referred close contacts to an app that provided tailored educational videos about vaccines along with a small pharmacy-based financial incentive for vaccine receipt. The primary objective of this study was to determine the feasibility of implementing this app-based cocooning intervention. RESULTS Two hundred seventy seven contacts were enrolled in this study. Of those who received the educational videos, 96% found them interesting, 100% found them clear to understand, 97% found them helpful, and 99% trusted them. Completion of the videos led to significant increases in influenza vaccine knowledge (p = 0.025), Tdap vaccine knowledge (p < 0.001), and intention to receive these vaccines (p = 0.046). Of the 136 participants who reported receiving influenza vaccine, 41 (30%) reported receiving it at a pharmacy, and of the 66 who reported receiving Tdap vaccine, 15 (23%) reported receiving it at a pharmacy. Of all participants, 80% reported being comfortable receiving vaccines at a pharmacy instead of a doctor's office. The provision of small pharmacy-based financial incentives combined with individually-tailored educational videos about vaccines led to 6.97 (95%CI: 2.25-21.64) times higher odds of self-reported receipt of influenza vaccine than providing small pharmacy-based financial incentives without these videos. No significant difference was found for Tdap vaccine. CONCLUSIONS Tailored vaccine education can positively impact vaccine knowledge and intentions among adults. An app-based referral program providing education and financial incentives for cocooning vaccination at pharmacies is feasible.
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Affiliation(s)
- Matthew Z Dudley
- Institute for Vaccine Safety, Johns Hopkins Bloomberg School of Public Health, 615 N. Wolfe Street, Baltimore, MD 21205, USA; Department of International Health, Johns Hopkins Bloomberg School of Public Health, 615 N. Wolfe Street, Baltimore, MD 21205, USA.
| | - Michael S Taitel
- Walgreens Center for Health and Wellbeing Research, Walgreen Company, 200 Wilmot Rd, Deerfield, IL 60015, USA
| | - Renae Smith-Ray
- Walgreens Center for Health and Wellbeing Research, Walgreen Company, 200 Wilmot Rd, Deerfield, IL 60015, USA
| | - Tanya Singh
- Walgreens Center for Health and Wellbeing Research, Walgreen Company, 200 Wilmot Rd, Deerfield, IL 60015, USA
| | - Rupali J Limaye
- Institute for Vaccine Safety, Johns Hopkins Bloomberg School of Public Health, 615 N. Wolfe Street, Baltimore, MD 21205, USA; Department of International Health, Johns Hopkins Bloomberg School of Public Health, 615 N. Wolfe Street, Baltimore, MD 21205, USA; Department of Health, Behavior and Society, Johns Hopkins Bloomberg School of Public Health, 615 N. Wolfe Street, Baltimore, MD 21205, USA; Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, 615 N. Wolfe Street, Baltimore, MD 21205, USA
| | - Daniel A Salmon
- Institute for Vaccine Safety, Johns Hopkins Bloomberg School of Public Health, 615 N. Wolfe Street, Baltimore, MD 21205, USA; Department of International Health, Johns Hopkins Bloomberg School of Public Health, 615 N. Wolfe Street, Baltimore, MD 21205, USA; Department of Health, Behavior and Society, Johns Hopkins Bloomberg School of Public Health, 615 N. Wolfe Street, Baltimore, MD 21205, USA
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4
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Omecene NE, Patterson JA, Bucheit JD, Anderson AN, Rogers D, Goode JV, Caldas LM. Implementation of pharmacist-administered pediatric vaccines in the United States: major barriers and potential solutions for the outpatient setting. Pharm Pract (Granada) 2019; 17:1581. [PMID: 31275506 PMCID: PMC6594428 DOI: 10.18549/pharmpract.2019.2.1581] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/31/2019] [Accepted: 06/14/2019] [Indexed: 11/14/2022] Open
Affiliation(s)
- Nicole E Omecene
- School of Pharmacy, Virginia Commonwealth University. Richmond, VA (United States).
| | - Julie A Patterson
- School of Pharmacy, Virginia Commonwealth University. Richmond, VA (United States).
| | - John D Bucheit
- School of Pharmacy, Virginia Commonwealth University. Richmond, VA (United States).
| | - Apryl N Anderson
- School of Pharmacy, Virginia Commonwealth University. Richmond, VA (United States).
| | - Danielle Rogers
- School of Pharmacy, Virginia Commonwealth University. Richmond, VA (United States).
| | - Jean V Goode
- School of Pharmacy, Virginia Commonwealth University. Richmond, VA (United States).
| | - Lauren M Caldas
- School of Pharmacy, Virginia Commonwealth University. Richmond, VA (United States).
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Kahn KE, Santibanez TA, Zhai Y, Bridges CB. Association between patient reminders and influenza vaccination status among children. Vaccine 2018; 36:8110-8118. [PMID: 30448063 PMCID: PMC6419731 DOI: 10.1016/j.vaccine.2018.10.029] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/29/2018] [Revised: 10/06/2018] [Accepted: 10/08/2018] [Indexed: 10/27/2022]
Abstract
BACKGROUND Patient reminders are recommended to increase vaccination rates. The objectives of this study were to estimate the percentage of children 6 months-17 years for whom a patient reminder for influenza vaccination was received by a child's parent or guardian, estimate influenza vaccination coverage by receipt of a patient reminder, and identify factors associated with receipt of a patient reminder. METHODS National Immunization Survey-Flu (NIS-Flu) data for the 2013-14 influenza season were analyzed. Tests of association between patient reminders and demographic characteristics were conducted using Wald chi-square tests and pairwise comparison t-tests. Multivariable logistic regression was used to determine variables independently associated with receiving a patient reminder. RESULTS Approximately 22% of children had a parent or guardian report receiving a patient reminder for influenza vaccination for their child, ranging from 12.9% in Idaho to 41.2% in Mississippi. Children with a patient reminder were more likely to be vaccinated compared with children without a patient reminder (73.7% versus 55.5%). In the multivariable model, reminder receipt was higher for children 6-23 months compared with children 13-17 years, black children compared with white children, and children whose parent completed the survey in English compared with children whose parent completed the survey in a language other than English or Spanish. CONCLUSIONS Although patient reminders are associated with a higher likelihood of influenza vaccination, nationally, less than one-fourth of children had a parent report receiving one. Despite being based on parental report, with its limitations, this study suggests that increasing the number of parents who receive patient reminders for their children may improve vaccination coverage among children.
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Affiliation(s)
- Katherine E Kahn
- Leidos, Inc., Atlanta, GA, USA; Centers for Disease Control and Prevention, Atlanta, GA, USA.
| | | | - Yusheng Zhai
- Leidos, Inc., Atlanta, GA, USA; Centers for Disease Control and Prevention, Atlanta, GA, USA
| | - Carolyn B Bridges
- Centers for Disease Control and Prevention, Atlanta, GA, USA; Berry Technology Solutions, Inc., Peachtree City, GA, USA
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Bartsch SM, Taitel MS, DePasse JV, Cox SN, Smith-Ray RL, Wedlock P, Singh TG, Carr S, Siegmund SS, Lee BY. Epidemiologic and economic impact of pharmacies as vaccination locations during an influenza epidemic. Vaccine 2018; 36:7054-7063. [PMID: 30340884 PMCID: PMC6279616 DOI: 10.1016/j.vaccine.2018.09.040] [Citation(s) in RCA: 20] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/21/2018] [Revised: 09/14/2018] [Accepted: 09/18/2018] [Indexed: 11/24/2022]
Abstract
Introduction: During an influenza epidemic, where early vaccination is crucial, pharmacies may be a resource to increase vaccine distribution reach and capacity. Methods: We utilized an agent-based model of the US and a clinical and economics outcomes model to simulate the impact of different influenza epidemics and the impact of utilizing pharmacies in addition to traditional (hospitals, clinic/physician offices, and urgent care centers) locations for vaccination for the year 2017. Results: For an epidemic with a reproductive rate (R0) of 1.30, adding pharmacies with typical business hours averted 11.9 million symptomatic influenza cases, 23,577 to 94,307 deaths, $1.0 billion in direct (vaccine administration and healthcare) costs, $4.2–44.4 billion in productivity losses, and $5.2–45.3 billion in overall costs (varying with mortality rate). Increasing the epidemic severity (R0 of 1.63), averted 16.0 million symptomatic influenza cases, 35,407 to 141,625 deaths, $1.9 billion in direct costs, $6.0–65.5 billion in productivity losses, and $7.8–67.3 billion in overall costs (varying with mortality rate). Extending pharmacy hours averted up to 16.5 million symptomatic influenza cases, 145,278 deaths, $1.9 billion direct costs, $4.1 billion in productivity loss, and $69.5 billion in overall costs. Adding pharmacies resulted in a cost-benefit of $4.1 to $11.5 billion, varying epidemic severity, mortality rate, pharmacy hours, location vaccination rate, and delay in the availability of the vaccine. Conclusions: Administering vaccines through pharmacies in addition to traditional locations in the event of an epidemic can increase vaccination coverage, mitigating up to 23.7 million symptomatic influenza cases, providing cost-savings up to $2.8 billion to third-party payers and $99.8 billion to society. Pharmacies should be considered as points of dispensing epidemic vaccines in addition to traditional settings as soon as vaccines become available.
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Affiliation(s)
- Sarah M Bartsch
- Public Health Computational and Operations Research (PHICOR), Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, United States; Global Obesity Prevention Center, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, United States
| | - Michael S Taitel
- Walgreens Center for Health & Wellbeing Research, Walgreens Company, Deerfield, IL, United States
| | - Jay V DePasse
- Pittsburgh Super Computing Center (PSC), Carnegie Mellon University, Pittsburgh, PA, United States
| | - Sarah N Cox
- Public Health Computational and Operations Research (PHICOR), Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, United States; Global Obesity Prevention Center, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, United States
| | - Renae L Smith-Ray
- Walgreens Center for Health & Wellbeing Research, Walgreens Company, Deerfield, IL, United States
| | - Patrick Wedlock
- Public Health Computational and Operations Research (PHICOR), Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, United States; Global Obesity Prevention Center, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, United States
| | - Tanya G Singh
- Walgreens Center for Health & Wellbeing Research, Walgreens Company, Deerfield, IL, United States
| | - Susan Carr
- Johns Hopkins Healthcare Solutions, Johns Hopkins University, Baltimore, MD, United States
| | - Sheryl S Siegmund
- Public Health Computational and Operations Research (PHICOR), Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, United States; Global Obesity Prevention Center, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, United States
| | - Bruce Y Lee
- Public Health Computational and Operations Research (PHICOR), Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, United States; Global Obesity Prevention Center, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, United States.
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7
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Calo WA, Gilkey MB, Shah P, Marciniak MW, Brewer NT. Parents' willingness to get human papillomavirus vaccination for their adolescent children at a pharmacy. Prev Med 2017; 99:251-256. [PMID: 28188796 PMCID: PMC5545978 DOI: 10.1016/j.ypmed.2017.02.003] [Citation(s) in RCA: 26] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/03/2016] [Revised: 02/03/2017] [Accepted: 02/06/2017] [Indexed: 11/18/2022]
Abstract
Pharmacies are promising alternative settings for human papillomavirus (HPV) vaccination because of their accessibility and existing infrastructure for vaccine delivery. We sought to examine parents' willingness to get HPV vaccination for their children at pharmacies. In 2014, we conducted a national, online survey of 1255 parents of 11- to 17-year-old adolescents in the United States. We used multivariable logistic regression to model parents' willingness for getting HPV vaccinations in pharmacies. Overall, 29% of parents would be willing to get HPV vaccine for their children at a pharmacy. Parental willingness was associated with believing that pharmacists are skilled at administering vaccines (OR=2.05, 95% CI:1.68-2.51), HPV vaccine was at least as important as other adolescent vaccines (OR=1.48, 95% CI:1.10-1.98), and getting vaccines in pharmacies would give children more opportunities to get health care (OR=2.17, 95% CI:1.63-2.89). Parental willingness was also more common among parents of adolescents ages 13-17 or who had already initiated the HPV vaccine series. Parents most often indicated that they would like to learn about HPV vaccination in pharmacies from their children's doctor (37%). Offering HPV vaccine in pharmacies may increase uptake as a meaningful number of parents would get the vaccine for their children in these settings. Physician referrals for completing the HPV vaccine series may serve as an important source for increasing awareness of and demand for adolescent vaccination services in pharmacies.
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Affiliation(s)
- William A Calo
- Department of Health Policy and Management, Gillings School of Global Public Health, University of North Carolina, Chapel Hill, NC, USA
| | - Melissa B Gilkey
- Department of Population Medicine, Harvard Medical School & Harvard Pilgrim Health Care Institute, Boston, MA, USA; Dana-Farber/Harvard Cancer Center, Boston, MA, USA
| | - Parth Shah
- Department of Health Behavior, Gillings School of Global Public Health, University of North Carolina, Chapel Hill, NC, USA; Cecil G. Sheps Center for Health Services Research, University of North Carolina, Chapel Hill, NC, USA
| | - Macary W Marciniak
- Division of Practice Advancement and Clinical Education, Eshelman School of Pharmacy, University of North Carolina, Chapel Hill, NC, USA
| | - Noel T Brewer
- Department of Health Behavior, Gillings School of Global Public Health, University of North Carolina, Chapel Hill, NC, USA; Lineberger Comprehensive Cancer Center, University of North Carolina, Chapel Hill, NC, USA.
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8
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Evaluating the Impact of Pharmacies on Pandemic Influenza Vaccine Administration. Disaster Med Public Health Prep 2017; 11:587-593. [PMID: 28219461 DOI: 10.1017/dmp.2017.1] [Citation(s) in RCA: 33] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Abstract
OBJECTIVES The objective of this study was to quantify the potential retail pharmacy vaccine administration capacity and its possible impact on pandemic influenza vaccine uptake. METHODS We developed a discrete event simulation model by use of ExtendSim software (Imagine That Inc, San Jose, CA) to forecast the potential effect of retail pharmacy vaccine administration on total weekly vaccine administration and the time needed to reach 80% vaccination coverage with a single dose of vaccine per person. RESULTS Results showed that weekly national vaccine administration capacity increased to 25 million doses per week when retail pharmacist vaccination capacity was included in the model. In addition, the time to achieve 80% vaccination coverage nationally was reduced by 7 weeks, assuming high public demand for vaccination. The results for individual states varied considerably, but in 48 states the inclusion of pharmacies improved time to 80% coverage. CONCLUSIONS Pharmacists can increase the numbers of pandemic influenza vaccine doses administered and reduce the time to achieve 80% single-dose coverage. These results support efforts to ensure pharmacist vaccinators are integrated into pandemic vaccine response planning. (Disaster Med Public Health Preparedness. 2017;11:587-593).
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Islam JY, Gruber JF, Lockhart A, Kunwar M, Wilson S, Smith SB, Brewer NT, Smith JS. Opportunities and Challenges of Adolescent and Adult Vaccination Administration Within Pharmacies in the United States. BIOMEDICAL INFORMATICS INSIGHTS 2017; 9:1178222617692538. [PMID: 28469431 PMCID: PMC5345946 DOI: 10.1177/1178222617692538] [Citation(s) in RCA: 27] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 10/11/2016] [Accepted: 01/04/2017] [Indexed: 11/16/2022]
Abstract
Pharmacies have been endorsed as alternative vaccine delivery sites to improve vaccination rates through increased access to services. Our objective was to identify challenges and facilitators to adolescent and adult vaccination provision in pharmacy settings in the United States. We recruited 40 licensed pharmacists in states with different pharmacy vaccination laws. Eligible pharmacists previously administered or were currently administering human papillomavirus (HPV); tetanus, diphtheria, and pertussis (TDAP); or meningitis (meningococcal conjugate vaccine [MCV4]) vaccines to adolescents aged 9 to 17 years. Pharmacists participated in a semistructured survey on in-pharmacy vaccine provision. Pharmacists commonly administered vaccinations to age-eligible adolescents and adults: influenza (100%, 100%), pneumococcal (35%, 98%), TDAP (80%, 98%), MCV4 (60%, 78%), and HPV (45%, 53%). Common challenges included reimbursement/insurance coverage (28%, 78%), education of patients/parents (30%, 40%), and pharmacists' time constraints (28%, 35%). Three-quarters of pharmacists reported that vaccination rates could be increased. National efforts should expand insurance coverage for vaccine administration reimbursement and improve data information systems to optimize provision within pharmacies.
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Affiliation(s)
- Jessica Y Islam
- Department of Epidemiology, Gillings School of Global Public Health, The University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
| | - Joann F Gruber
- Department of Epidemiology, Gillings School of Global Public Health, The University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
| | - Alexandre Lockhart
- Department of Epidemiology, Gillings School of Global Public Health, The University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
| | - Manju Kunwar
- Department of Maternal and Child Health, Gillings School of Global Public Health, The University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
| | - Spencer Wilson
- School of Medicine, The University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
| | - Sara B Smith
- Department of Epidemiology, Gillings School of Global Public Health, The University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
| | - Noel T Brewer
- Department of Health Behavior, Gillings School of Global Public Health, The University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
- Lineberger Comprehensive Cancer Center, School of Medicine, The University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
| | - Jennifer S Smith
- Department of Epidemiology, Gillings School of Global Public Health, The University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
- Lineberger Comprehensive Cancer Center, School of Medicine, The University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
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10
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Hattingh HL, Sim TF, Parsons R, Czarniak P, Vickery A, Ayadurai S. Evaluation of the first pharmacist-administered vaccinations in Western Australia: a mixed-methods study. BMJ Open 2016; 6:e011948. [PMID: 27650763 PMCID: PMC5051390 DOI: 10.1136/bmjopen-2016-011948] [Citation(s) in RCA: 43] [Impact Index Per Article: 5.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/06/2022] Open
Abstract
OBJECTIVES This study evaluated the uptake of Western Australian (WA) pharmacist vaccination services, the profiles of consumers being vaccinated and the facilitators and challenges experienced by pharmacy staff in the preparation, implementation and delivery of services. DESIGN Mixed-methods methodology with both quantitative and qualitative data through surveys, pharmacy computer records and immuniser pharmacist interviews. SETTING Community pharmacies in WA that provided pharmacist vaccination services between March and October 2015. PARTICIPANTS Immuniser pharmacists from 86 pharmacies completed baseline surveys and 78 completed exit surveys; computer records from 57 pharmacies; 25 immuniser pharmacists were interviewed. MAIN OUTCOME MEASURES Pharmacy and immuniser pharmacist profiles; pharmacist vaccination services provided and consumer profiles who accessed services. RESULTS 15 621 influenza vaccinations were administered by immuniser pharmacists at 76 WA community pharmacies between March and October 2015. There were no major adverse events, and <1% of consumers experienced minor events which were appropriately managed. Between 12% and 17% of consumers were eligible to receive free influenza vaccinations under the National Immunisation Program but chose to have it at a pharmacy. A high percentage of vaccinations was delivered in rural and regional areas indicating that provision of pharmacist vaccination services facilitated access for rural and remote consumers. Immuniser pharmacists reported feeling confident in providing vaccination services and were of the opinion that services should be expanded to other vaccinations. Pharmacists also reported significant professional satisfaction in providing the service. All participating pharmacies intended to continue providing influenza vaccinations in 2016. CONCLUSIONS This initial evaluation of WA pharmacist vaccination services showed that vaccine delivery was safe. Convenience and accessibility were important aspects in usage of services. There is scope to expand pharmacist vaccination services to other vaccines and younger children; however, government funding to pharmacists needs to be considered.
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Affiliation(s)
- H Laetitia Hattingh
- Faculty of Health Sciences, School of Pharmacy, Curtin University, Perth, Western Australia, Australia
| | - T Fei Sim
- Faculty of Health Sciences, School of Pharmacy, Curtin University, Perth, Western Australia, Australia
| | - R Parsons
- Faculty of Health Sciences, School of Occupational Health & Social Work and School Pharmacy, Curtin University, Perth, Western Australia, Australia
| | - P Czarniak
- Faculty of Health Sciences, School of Pharmacy, Curtin University, Perth, Western Australia, Australia
| | - A Vickery
- Department of General Practice, The University of Western Australia, Perth, Western Australia, Australia
| | - S Ayadurai
- Faculty of Health Sciences, School of Pharmacy, Curtin University, Perth, Western Australia, Australia
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11
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Buchan SA, Rosella LC, Finkelstein M, Juurlink D, Isenor J, Marra F, Patel A, Russell ML, Quach S, Waite N, Kwong JC. Impact of pharmacist administration of influenza vaccines on uptake in Canada. CMAJ 2016; 189:E146-E152. [PMID: 27503864 DOI: 10.1503/cmaj.151027] [Citation(s) in RCA: 50] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/08/2016] [Accepted: 04/22/2016] [Indexed: 11/01/2022] Open
Abstract
BACKGROUND Uptake of influenza vaccination in Canada remains suboptimal despite widespread public funding. To increase access, several provinces have implemented policies permitting pharmacists to administer influenza vaccines in community pharmacies. We examined the impact of such policies on the uptake of seasonal influenza vaccination in Canada. METHODS We pooled data from the 2007-2014 cycles of the Canadian Community Health Survey (n = 481 526). To determine the impact of influenza vaccine administration by pharmacists, we estimated the prevalence ratio for the association between the presence of a pharmacist policy and individual-level vaccine uptake using a modified Poisson regression model (dependent variable: vaccine uptake) with normalized weights while controlling for numerous health and sociodemographic factors. RESULTS Across all survey cycles combined, 28.8% of respondents reported receiving a seasonal influenza vaccine during the 12 months before survey participation. Introduction of a policy for pharmacist administration of influenza vaccine was associated with a modest increase in coverage (2.2%) and an individual's likelihood of uptake (adjusted prevalence ratio 1.05, 95% confidence interval 1.02-1.08). INTERPRETATION Uptake of influenza immunization was modestly increased in Canadian jurisdictions that allowed pharmacists to administer influenza vaccines.
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Affiliation(s)
- Sarah A Buchan
- Epidemiology Division (Buchan, Rosella, Kwong), Dalla Lana School of Public Health, University of Toronto; Toronto Public Health (Finkelstein); Institute for Clinical Evaluative Sciences (Juurlink, Kwong), Toronto, Ont.; College of Pharmacy and Faculty of Medicine (Isenor), Dalhousie University, Halifax, NS; Faculty of Pharmaceutical Sciences (Marra) and Faculty of Medicine (Patel), University of British Columbia, Vancouver, BC; Cumming School of Medicine (Russell), University of Calgary, Calgary, Alta.; Public Health Ontario (Rosella, Quach, Kwong), Toronto, Ont.; School of Pharmacy (Waite), University of Waterloo, Waterloo, Ont
| | - Laura C Rosella
- Epidemiology Division (Buchan, Rosella, Kwong), Dalla Lana School of Public Health, University of Toronto; Toronto Public Health (Finkelstein); Institute for Clinical Evaluative Sciences (Juurlink, Kwong), Toronto, Ont.; College of Pharmacy and Faculty of Medicine (Isenor), Dalhousie University, Halifax, NS; Faculty of Pharmaceutical Sciences (Marra) and Faculty of Medicine (Patel), University of British Columbia, Vancouver, BC; Cumming School of Medicine (Russell), University of Calgary, Calgary, Alta.; Public Health Ontario (Rosella, Quach, Kwong), Toronto, Ont.; School of Pharmacy (Waite), University of Waterloo, Waterloo, Ont
| | - Michael Finkelstein
- Epidemiology Division (Buchan, Rosella, Kwong), Dalla Lana School of Public Health, University of Toronto; Toronto Public Health (Finkelstein); Institute for Clinical Evaluative Sciences (Juurlink, Kwong), Toronto, Ont.; College of Pharmacy and Faculty of Medicine (Isenor), Dalhousie University, Halifax, NS; Faculty of Pharmaceutical Sciences (Marra) and Faculty of Medicine (Patel), University of British Columbia, Vancouver, BC; Cumming School of Medicine (Russell), University of Calgary, Calgary, Alta.; Public Health Ontario (Rosella, Quach, Kwong), Toronto, Ont.; School of Pharmacy (Waite), University of Waterloo, Waterloo, Ont
| | - David Juurlink
- Epidemiology Division (Buchan, Rosella, Kwong), Dalla Lana School of Public Health, University of Toronto; Toronto Public Health (Finkelstein); Institute for Clinical Evaluative Sciences (Juurlink, Kwong), Toronto, Ont.; College of Pharmacy and Faculty of Medicine (Isenor), Dalhousie University, Halifax, NS; Faculty of Pharmaceutical Sciences (Marra) and Faculty of Medicine (Patel), University of British Columbia, Vancouver, BC; Cumming School of Medicine (Russell), University of Calgary, Calgary, Alta.; Public Health Ontario (Rosella, Quach, Kwong), Toronto, Ont.; School of Pharmacy (Waite), University of Waterloo, Waterloo, Ont
| | - Jennifer Isenor
- Epidemiology Division (Buchan, Rosella, Kwong), Dalla Lana School of Public Health, University of Toronto; Toronto Public Health (Finkelstein); Institute for Clinical Evaluative Sciences (Juurlink, Kwong), Toronto, Ont.; College of Pharmacy and Faculty of Medicine (Isenor), Dalhousie University, Halifax, NS; Faculty of Pharmaceutical Sciences (Marra) and Faculty of Medicine (Patel), University of British Columbia, Vancouver, BC; Cumming School of Medicine (Russell), University of Calgary, Calgary, Alta.; Public Health Ontario (Rosella, Quach, Kwong), Toronto, Ont.; School of Pharmacy (Waite), University of Waterloo, Waterloo, Ont
| | - Fawziah Marra
- Epidemiology Division (Buchan, Rosella, Kwong), Dalla Lana School of Public Health, University of Toronto; Toronto Public Health (Finkelstein); Institute for Clinical Evaluative Sciences (Juurlink, Kwong), Toronto, Ont.; College of Pharmacy and Faculty of Medicine (Isenor), Dalhousie University, Halifax, NS; Faculty of Pharmaceutical Sciences (Marra) and Faculty of Medicine (Patel), University of British Columbia, Vancouver, BC; Cumming School of Medicine (Russell), University of Calgary, Calgary, Alta.; Public Health Ontario (Rosella, Quach, Kwong), Toronto, Ont.; School of Pharmacy (Waite), University of Waterloo, Waterloo, Ont
| | - Anik Patel
- Epidemiology Division (Buchan, Rosella, Kwong), Dalla Lana School of Public Health, University of Toronto; Toronto Public Health (Finkelstein); Institute for Clinical Evaluative Sciences (Juurlink, Kwong), Toronto, Ont.; College of Pharmacy and Faculty of Medicine (Isenor), Dalhousie University, Halifax, NS; Faculty of Pharmaceutical Sciences (Marra) and Faculty of Medicine (Patel), University of British Columbia, Vancouver, BC; Cumming School of Medicine (Russell), University of Calgary, Calgary, Alta.; Public Health Ontario (Rosella, Quach, Kwong), Toronto, Ont.; School of Pharmacy (Waite), University of Waterloo, Waterloo, Ont
| | - Margaret L Russell
- Epidemiology Division (Buchan, Rosella, Kwong), Dalla Lana School of Public Health, University of Toronto; Toronto Public Health (Finkelstein); Institute for Clinical Evaluative Sciences (Juurlink, Kwong), Toronto, Ont.; College of Pharmacy and Faculty of Medicine (Isenor), Dalhousie University, Halifax, NS; Faculty of Pharmaceutical Sciences (Marra) and Faculty of Medicine (Patel), University of British Columbia, Vancouver, BC; Cumming School of Medicine (Russell), University of Calgary, Calgary, Alta.; Public Health Ontario (Rosella, Quach, Kwong), Toronto, Ont.; School of Pharmacy (Waite), University of Waterloo, Waterloo, Ont
| | - Susan Quach
- Epidemiology Division (Buchan, Rosella, Kwong), Dalla Lana School of Public Health, University of Toronto; Toronto Public Health (Finkelstein); Institute for Clinical Evaluative Sciences (Juurlink, Kwong), Toronto, Ont.; College of Pharmacy and Faculty of Medicine (Isenor), Dalhousie University, Halifax, NS; Faculty of Pharmaceutical Sciences (Marra) and Faculty of Medicine (Patel), University of British Columbia, Vancouver, BC; Cumming School of Medicine (Russell), University of Calgary, Calgary, Alta.; Public Health Ontario (Rosella, Quach, Kwong), Toronto, Ont.; School of Pharmacy (Waite), University of Waterloo, Waterloo, Ont
| | - Nancy Waite
- Epidemiology Division (Buchan, Rosella, Kwong), Dalla Lana School of Public Health, University of Toronto; Toronto Public Health (Finkelstein); Institute for Clinical Evaluative Sciences (Juurlink, Kwong), Toronto, Ont.; College of Pharmacy and Faculty of Medicine (Isenor), Dalhousie University, Halifax, NS; Faculty of Pharmaceutical Sciences (Marra) and Faculty of Medicine (Patel), University of British Columbia, Vancouver, BC; Cumming School of Medicine (Russell), University of Calgary, Calgary, Alta.; Public Health Ontario (Rosella, Quach, Kwong), Toronto, Ont.; School of Pharmacy (Waite), University of Waterloo, Waterloo, Ont
| | - Jeffrey C Kwong
- Epidemiology Division (Buchan, Rosella, Kwong), Dalla Lana School of Public Health, University of Toronto; Toronto Public Health (Finkelstein); Institute for Clinical Evaluative Sciences (Juurlink, Kwong), Toronto, Ont.; College of Pharmacy and Faculty of Medicine (Isenor), Dalhousie University, Halifax, NS; Faculty of Pharmaceutical Sciences (Marra) and Faculty of Medicine (Patel), University of British Columbia, Vancouver, BC; Cumming School of Medicine (Russell), University of Calgary, Calgary, Alta.; Public Health Ontario (Rosella, Quach, Kwong), Toronto, Ont.; School of Pharmacy (Waite), University of Waterloo, Waterloo, Ont.
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Atkins K, van Hoek AJ, Watson C, Baguelin M, Choga L, Patel A, Raj T, Jit M, Griffiths U. Seasonal influenza vaccination delivery through community pharmacists in England: evaluation of the London pilot. BMJ Open 2016; 6:e009739. [PMID: 26883237 PMCID: PMC4762088 DOI: 10.1136/bmjopen-2015-009739] [Citation(s) in RCA: 30] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/07/2022] Open
Abstract
OBJECTIVE To evaluate the effectiveness and cost of the pan-London pharmacy initiative, a programme that allows administration of seasonal influenza vaccination to eligible patients at pharmacies. DESIGN We analysed 2013-2015 data on vaccination uptake in pharmacies via the Sonar reporting system, and the total vaccination uptake via 2011-2015 ImmForm general practitioner (GP) reporting system data. We conducted an online survey of London pharmacists who participate in the programme to assess time use data, vaccine choice, investment costs and opinions about the programme. We conducted an online survey of London GPs to assess vaccine choice of vaccine and opinions about the pharmacy vaccine delivery programme. SETTING All London boroughs. PARTICIPANTS London-based GPs, and pharmacies that currently offer seasonal flu vaccination. INTERVENTIONS Not applicable. MAIN OUTCOME MEASURES Comparison of annual vaccine uptake in London across risk groups from years before pharmacy vaccination introduction to after pharmacy vaccination introduction. Completeness of vaccine uptake reporting data. Cost to the National Health Service (NHS) of flu vaccine delivery at pharmacies with that at GPs. Cost to pharmacists of flu delivery. Opinions of pharmacists and GPs regarding the flu vaccine pharmacy initiative. RESULTS No significant change in the uptake of seasonal vaccination in any of the risk groups as a result of the pharmacy initiative. While on average a pharmacy-administered flu vaccine dose costs the NHS up to £2.35 less than a dose administered at a GP, a comparison of the 2 recording systems suggests there is substantial loss of data. CONCLUSIONS Flu vaccine delivery through pharmacies shows potential for improving convenience for vaccine recipients. However, there is no evidence that vaccination uptake increases and the use of 2 separate recording systems leads to time-consuming data entry and missing vaccine record data.
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Affiliation(s)
- Katherine Atkins
- Department of Infectious Disease Epidemiology, Faculty of Epidemiology and Population Health, London School of Hygiene and Tropical Medicine, London, UK
| | - Albert Jan van Hoek
- Department of Infectious Disease Epidemiology, Faculty of Epidemiology and Population Health, London School of Hygiene and Tropical Medicine, London, UK
| | - Conall Watson
- Department of Infectious Disease Epidemiology, Faculty of Epidemiology and Population Health, London School of Hygiene and Tropical Medicine, London, UK
| | - Marc Baguelin
- Department of Infectious Disease Epidemiology, Faculty of Epidemiology and Population Health, London School of Hygiene and Tropical Medicine, London, UK
- Respiratory Disease Department, Public Health England, London, UK
| | | | - Anika Patel
- Imperial GP Specialty Training, Department of Primary Care and Public Health, Imperial College London, London, UK
| | - Thara Raj
- Screening and Immunisations, London Region, Public Health England, London, UK
| | - Mark Jit
- Department of Infectious Disease Epidemiology, Faculty of Epidemiology and Population Health, London School of Hygiene and Tropical Medicine, London, UK
- Respiratory Disease Department, Public Health England, London, UK
| | - Ulla Griffiths
- Department of Global Health, Faculty of Public Health and Policy, London School of Hygiene and Tropical Medicine, London, UK
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Haga SB. Delivering pharmacogenetic testing to the masses: an achievable goal? Pharmacogenomics 2014; 15:1-4. [DOI: 10.2217/pgs.13.211] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022] Open
Affiliation(s)
- Susanne B Haga
- Institute for Genome Sciences & Policy & Sanford School of Public Policy, Duke University, 304 Research Drive, Box 90141, Durham, NC 27708, USA
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