Nancy Waite

A literature review of the impact of pharmacy students in immunization initiatives.

Background: Pharmacy students can help protect the public from vaccine-preventable diseases by participating in immunization initiatives, which currently exist in some Canadian and American jurisdictions. The objective of this article is to critically review evidence of student impact on public health through their participation in vaccination efforts. Methods: PubMed, CINAHL, Cochrane Database, EMBASE, International Pharmaceutical Abstracts, Scopus and Web of Science electronic databases were searched for peer-reviewed literature on pharmacy student involvement in vaccination programs and their impact on public health. Papers were included up to November 17, 2015. Two reviewers independently screened titles and abstracts and extracted data from eligible full-text articles. Results: Eighteen titles met all inclusion criteria. All studies were published between 2000 and 2015, with the majority conducted in the United States (n = 12). The number of vaccine doses administered by students in community-based clinics ranged from 109 to 15,000. Increases in vaccination rates in inpatient facilities ranged from 18.5% to 68%. Across studies, student-led educational interventions improved patient knowledge of vaccines and vaccine-preventable diseases. Patient satisfaction with student immunization services was consistently very high. Discussion: Methodology varied considerably across studies. The literature suggests that pharmacy students can improve public health by 1) increasing the number of vaccine doses administered, 2) increasing vaccination rates, 3) increasing capacity of existing vaccination efforts, 4) providing education about vaccines and vaccine-preventable diseases and 5) providing positive immunization experiences. Conclusion: Opportunities exist across Canada to increase pharmacy student involvement in immunization efforts and to assess the impact of their participation. Greater student involvement in immunization initiatives could boost immunization rates and help protect Canadians from vaccine-preventable diseases.

Protecting our patients by protecting ourselves: An analysis of the personal influenza immunization rate of Ontario community pharmacists.

Background: With recent expansions to scope of practice that have allowed Canadian pharmacists to play a larger role in administering influenza vaccinations to the public, it is important that pharmacists themselves meet Canadian guidelines recommending that 80% of health care professionals and 100% of vaccinators receive an annual influenza vaccination. Unvaccinated health care professionals pose an infection risk to patients they serve and are at an increased risk of infection themselves. Methods: An online, anonymous survey was sent to Ontario community pharmacists to determine whether they had received the influenza vaccination during the 2013–2014 influenza season. All significant univariate chi-square analysis respondent characteristics were included in a multivariate regression analysis model to determine predictors of vaccination status. Results: A total of 780 pharmacists completed the survey (18.1% response rate), which showed that 7 in 10 Ontario community pharmacists received the influenza vaccine. Those certified to immunize were nearly 3 times more likely to have received the influenza vaccine than those not certified (81.6% versus 61.2%, respectively). Discussion: Having 70% of Ontario community pharmacists vaccinated against influenza is both an accomplishment and an opportunity to improve vaccination rates. While similar to the influenza immunization rates of other health care professions, Ontario community pharmacists did not meet Public Health Canada’s recommendations. Comprehensive worksite programs, including promotion, education and convenient access to influenza vaccination at no cost, could increase community pharmacist influenza vaccination rates. Conclusion: The authors issue a call to arms to encourage all pharmacists to receive the influenza vaccine to protect the public and themselves.

Pharmacy patron perspectives of community pharmacist administered influenza vaccinations

Background: One approach to boost influenza vaccination coverage has been to expand immunization authority. In 2012, the province of Ontario gave community pharmacists the authority to administer the influenza vaccine. Objective: This study investigates the perspectives of Ontario pharmacy patrons, who had not recently received this vaccine from a pharmacist, regarding this pharmacist service. Methods: A survey was administered in six Ontario community pharmacies to pharmacy patrons who had not received an influenza vaccination from a pharmacist during the previous year. The instrument included questions about influenza vaccination, and knowledge of and attitudes toward vaccines and pharmacist‐administered immunization. Results: A total of 541 pharmacy patrons completed the survey (53.9% response rate). About one‐third (30.5%) of respondents were not aware that pharmacists could give the influenza vaccine, with younger individuals being less likely to be aware (OR 0.48, 95% CI 0.29–0.77, p < 0.05) and less likely to receive the vaccine annually (OR 0.28, 95% CI 0.19–0.42, p < 0.05). Leading reasons respondents gave as to why they did not receive their influenza vaccine from a pharmacist included not wanting or feeling they needed to be immunized (41.6%) and being used to receiving the vaccine from a physician (16.5%). Concerns about the experience and training of pharmacists and lack of privacy in a community pharmacy were uncommon. Conclusion: Reduced awareness of the availability of pharmacist‐provided influenza vaccine is still common. Pharmacists have a significant opportunity to address lack of awareness and vaccine hesitancy issues. They can promote this service to increase influenza vaccination rates among pharmacy patrons who do not utilize this professional service.

Canadian older adults’ perceptions of effectiveness and value of regular and high-dose influenza vaccines

ABSTRACT Influenza vaccination is an important public health intervention for older adults, yet vaccination rates remain suboptimal. We conducted an online survey of Canadians ≥ 65 years to explore satisfaction with publicly-funded standard-dose influenza vaccines, and perceptions of the need for a more effective product. They were provided with information about currently approved influenza vaccines, and were asked about their preferences should all formulations be available for free, and should the recently approved high-dose (HD) vaccine for seniors be available at a cost. From March to April 2017, 5014 seniors completed the survey; mean age was 71.3 ± 5.17 years, 50% were female, and 42.6% had one or more chronic conditions. 3403 (67.9%) had been vaccinated against influenza in the 2016/17 season. Of all respondents, 3460 (69%) were satisfied with the standard-dose influenza vaccines, yet 3067 (61.1%) thought that a more effective vaccine was/may be needed. If HD was only available at a cost, 1426 (28.4%) respondents would consider it, of whom 62.9% would pay

Pharmacists as immunizers, their pharmacies and immunization services: A survey of Ontario community pharmacists:

20 or less. If all vaccines were free next season, 1914 (38.2%) would opt for HD (including 12.2% of those who previously rejected influenza vaccines), 856 (17.1%) would choose adjuvanted vaccine, and 558 (11.1%) standard-dose vaccine. 843 (16.8%) of respondents were against vaccines, 451 (9.0%) had no preference and 392 (7.8%) were uncertain. Making this product available through publicly funded programs may be a strategy to increase immunization rates in this population.

Sex and gender-based analysis in pharmacy practice research: a scoping review

Background: To improve patient access to the influenza vaccine in Ontario, pharmacists have been authorized to administer the vaccine since 2012. A survey was conducted to describe pharmacist immunizers, their pharmacies and immunization services. Methods: Ontario community pharmacists completed an anonymous online survey regarding influenza immunization. Descriptive, comparative and multivariate statistics were used to analyze data on pharmacists’ personal demographics, current workplace characteristics, immunization certification status and past and anticipated experience vaccinating. Results: Of the 4307 community pharmacists contacted, 18.4% (n = 780) completed the survey. Most (81.3%, n = 603) were certified to administer vaccines, with those practising in urban pharmacies twice as likely to be certified compared to pharmacists practising in rural pharmacies (odds ratio = 2.04; 95% confidence interval, 1.04 to 4.01, p = 0.04). In the past influenza season, 70% of pharmacists had administered over 50 vaccines and 37% worked at pharmacies that had administered more than 300 vaccines. Respondent-provided profiles of immunization services described partnerships with public health, a variety of approaches for in-pharmacy and external advertising and patient vaccine access mainly through walk-in. Discussion: Ontario community pharmacists demonstrate strong engagement with this expanded scope and there is further capacity for immunization service provision through engaging rural pharmacies, addition of other vaccines and leveraging the positive relationship with public health. Patients and the public benefit from easy access to the service and the additional in-store and external promotion of influenza vaccination that is provided by pharmacists and pharmacies. Conclusion: These provincial benchmarking data provide direction for maintaining and expanding community pharmacist-provided influenza immunization.

Incorporating sex, gender and vulnerable populations in a large multisite health research programme: The Ontario Pharmacy Evidence Network as a case study

Background: Recognizing the potential effect of sex and gender on health outcomes, there is a shift toward conducting sex and gender‐based analysis (SGBA) within health research. However, little is known about the extent to which SGBA has been incorporated into pharmacy practice research. Objectives: To understand the extent to which SGBA is included in pharmacy practice research. Method: Scoping review of English‐language studies identified through MEDLINE, Embase, International Pharmacy Abstracts (IPA), and CINAHL (inception to Jan 2014). Two raters independently screened citations to identify titles and abstracts that included key words related to sex or gender and studies that could be categorized as pharmacy practice research. One author extracted data from included studies related to study design, population, intervention/exposure and outcomes, with results reviewed by another. All authors reviewed eligible articles to categorize them based on a previously‐developed typology, and to assess four criteria: 1) the inclusion of sex or gender in research objectives, 2) the depth of sex/gender analysis incorporated into study designs and reporting, 3) the inclusion of sex or gender considerations in interpretation of study results, 4) the intentional and accurate use of sex/gender language. Results: Of 458 unique search results, only six articles met the inclusion criteria. Two of these six publications included sex/gender considerations in a model consistent with sex/gender based analysis as described by Hammarström. Three of the six studies inaccurately applied sex and gender terminology, whereas the two studies that featured sex or gender in their primary research question did use these terms appropriately. Conclusion: Despite increasing attention on the need for considering sex and gender, there was a paucity of pharmacy practice research publications that conducted SGBA. This presents an opportunity to explore sex, gender and intersectionality when pursuing studies that explore the impact of pharmacists interventions on patient outcomes. HighlightsThe purpose was to understand how sex and gender have been incorporated into pharmacy practice research (PPR).Sex and gender have been identified as important to consider in health research.“Sex and gender‐based analyses” (SGBA) are an approach for considering both social and biological aspects of sex and gender.A scoping review of PPR literature published before 2014 found 6 of 458 articles that addressed sex and gender directly.Only two were identified as taking an SGBA approach, taking sex or gender as a primary research question. &NA; Sex and gender based analysis (SGBA) is identified as important for health research, yet a scoping review of pharmacy practice research reveals limited use of SGBA. Future research should use SGBA to promote inclusivity.

Pharmacist provision of primary health care: a modified Delphi validation of pharmacists' competencies

BackgroundFunders now frequently require that sex and gender be considered in research programmes, but provide little guidance about how this can be accomplished, especially in large research programmes. The purpose of this study is to present and evaluate a model for promoting sex- and gender-based analysis (SGBA) in a large health service research programme, the Ontario Pharmacy Evidence Network (OPEN).MethodsA mixed method study incorporating (1) team members’ critical reflection, (2) surveys (n = 37) and interviews (n = 23) at programme midpoint, and (3) an end-of-study survey in 2016 with OPEN research project teams (n = 6).ResultsIncorporating gender and vulnerable populations (GVP) as a cross-cutting theme, with a dedicated team and resources to promote GVP research across the programme, was effective and well received. Team members felt their knowledge was improved, and the programme produced several sex- and gender-related research outputs. Not all resources were well used, however, and better communication of the purposes and roles of the team could increase effectiveness.ConclusionsThe experience of OPEN suggests that dedicating resources for sex and gender research can be effective in promoting SGBA research, but that research programmes should also focus on communicating the importance of SGBA to their members.