Call to expand access to vaccines for children through pharmacist education, collaboration, and advocacy

Evaluation of Pediatric-Focused Immunization Training Offerings at United States Schools and Colleges of Pharmacy

OBJECTIVE

To determine the prevalence, describe the content, and identify barriers to implementing pediatric-focused immunization training at United States (US) schools and colleges of pharmacy.

METHODS

A cross-sectional survey was distributed to members of the American Association of Colleges of Pharmacy Laboratory Instructors Special Interest Group. The 22-item survey included multiple-choice, Likert scale, and select-all-that-apply questions. Skip logic was applied based on respondents' selections. Descriptive statistics were used for data analysis.

RESULTS

The response rate was 59.7% (71/119), with 58% of respondents from public institutions and 42% from private institutions. Nearly all respondents participated in immunization training at their institution as a program coordinator, didactic teacher, and/or technique assessment facilitator. Pediatric-focused immunization training was not offered by 72% of programs. Among programs that provided pediatric-focused training, the most common topics included administration strategies and correct injection techniques. The most frequently reported barriers to implementing pediatric-focused immunization training were limited curriculum space, cost to the school/college, facilitator comfort, and instructor workload.

CONCLUSION

Despite pharmacists' expanded scope to administer immunizations to pediatric patients under the Public Readiness and Emergency Preparedness Act, most US schools and colleges of pharmacy do not offer pediatric-focused immunization training to student pharmacists. The most commonly reported barriers to implementation may be addressed by enhancing pediatric content in existing immunization certificate programs used within schools and colleges of pharmacy.

A Scoping Review of Calls to Action in Pharmacy Education

OBJECTIVES

Calls to action in pharmacy education are frequently observed in the literature, with little information about their authors, audience, or focus, especially regarding whether these calls led to any changes. This scoping review aims to (1) quantitatively and qualitatively characterize the calls to action in pharmacy education and (2) examine the traits of published articles typically associated with effective advocacy.

FINDINGS

A systematic literature search for the scoping review was conducted using the PRISMA Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. Of 3287 articles, 232 were included and extracted for their specific call to action, including topics, audience, and call quality. Two-thirds (66.7%) of the calls were initiated by faculty groups, 49% were commentaries, opinions, or editorials, and 39% were focused on the Doctor of Pharmacy curriculum. More than 90% of the articles were published between 2013 and 2023, with 26% published in 2023 alone. Most calls were directed to colleges/schools of pharmacy (81%). Only 21% of articles had a strong call to action with next steps or recommendations for enacting change.

SUMMARY

The most frequently published calls to action were related to the pharmacy curriculum, authored by faculty groups, directed to pharmacy programs, and published in the postpandemic years, but were often not sufficiently strong to elicit change. To evoke change, calls to action should include several key characteristics according to this scoping review, such as being written in active voice, to a specific audience, with clearly stated problems, and with actionable solutions that could be implemented.

Focused Preceptor Feedback Assessing Student Pharmacists' Ability to Administer Pediatric Immunizations

OBJECTIVE

To evaluate experiential pharmacy preceptor perceptions of student pharmacists' ability to administer pediatric immunizations.

METHODS

Semi-structured, qualitative key informant interviews using the Outcomes Evaluation Framework were conducted with 10 pharmacist preceptors in outpatient community pharmacies where pediatric immunizations were provided. Interviews were audio-recorded, transcribed, and deidentified prior to analysis by the research team. Qualitative analysis and thematic coding procedures were used to identify relevant themes.

RESULTS

Saturation was met after 10 pharmacists participated. All stated that it was beneficial for student pharmacists to administer pediatric vaccines if trained in proper technique. Participants acknowledged that the training students currently receive in immunization administration within the PharmD curriculum is valuable but did identify general confidence and child-comforting techniques during and after vaccination as areas of improvement for students. Just-in-time training, preceptor coaching, and hands-on practice outside of the didactic curriculum were utilized to help build confidence. Barriers to the implementation or expansion of pediatric immunization delivered by students in community pharmacies were identified as competing priorities, time, and reimbursement.

CONCLUSION

Student pharmacists can be helpful in easing the challenges of incorporating pediatric immunization services into the community pharmacy setting. Results demonstrate that the integration of student pharmacists into these services is beneficial. Pediatric immunizations are still relatively new to many pharmacists and specific training for pediatric immunization administration may not be integrated into all Doctor of Pharmacy curricula but the experiential education of pediatric immunization training can be beneficial to help prepare student pharmacists for hands-on practice.

Factors Associated with the Implementation of Pediatric Immunization Services: A Survey of Community Pharmacies

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.

Why can't we be friends? The manufactured fear of pharmacist "scope creep"

The American Medical Association has engaged in a longitudinal campaign against "scope creep" in other health care professions, characterized as a threat to patient safety. Arguments made by the organization regarding the lack of training and ability of pharmacists to engage in services beyond dispensing fail to accurately characterize our value. The expansion of pharmacist scope of practice has support across much of the health care community and is further reinforced by ample scientific evidence. In addition, already existing models of expanded scope are available in many states and several other countries. Now, more than ever, professional organizations within medicine and pharmacy should focus their efforts on solving a myriad of pressing issues for health care workers and patients, as opposed to engaging in turf battles.