Determinants to immunization information system implementation in independent community pharmacies in rural Alabama

Factors influencing immunization record retrieval from immunization information systems among independent community pharmacies: A National Survey

Background/objectives

Community pharmacies may not consistently check patients' immunization records from Immunization Information Systems (IIS) before administering vaccines. Therefore, this study aimed to identify key factors associated with vaccine records retrieval from IIS among community pharmacies.

Methods

A cross-sectional survey of 9446 members of the United States National Community Pharmacists Association was conducted from September-November 2022. There were 492 responses (response rate 5.2 %) received. The analysis included 202 participants who provided immunization services in 2021, administered vaccines besides COVID-19 or influenza, and completed ≥80 % of the questionnaire. The dependent variable was participants' self-reported frequency of retrieving immunization records from IIS (categorized as high or low IIS users). The independent variables considered were participant/pharmacy characteristics, IIS knowledge and perceptions about innovation characteristics, process, and inner settings, as identified by the Consolidated Framework for Implementation Research. Exploratory factor analysis identified ten perception scales, and all had Cronbach's Alpha coefficient of >0.70.

Results

Approximately 65 % of the respondents were high IIS users ("frequently"/"always") while 35 % were low IIS users ("never"/"rarely"/"occasionally"). A bivariate analyses of the relationship between the dependent and independent variables indicated significant differences in job title, state requirement for documentation in IIS, and eight scales: perceived benefit of IIS in consolidating patient records, optimizing immunization service delivery process, perceived IIS usability, process of engaging staff in IIS implementation, leadership support in encouraging IIS utilization, team values, open communications, and organizational needs fulfillment. A multivariable logistic regression analysis revealed that process optimization (p = .009) and leadership support (p = .018) were the two significant predictors of being in the high IIS user group when accounting for other variables.

Conclusion

Interventions to encourage independent community pharmacies to retrieve vaccine records from IIS should focus on enhancing the efficiency of the IIS process and leadership support.

Quality and safety requirements for pharmacy-based vaccination in resource-limited countries

Pharmacy-based vaccination (PBV) programs have proven to be a promising strategy for improving vaccination coverage, particularly in resource-limited countries. These programs increase accessibility and convenience, increase vaccination rates, and benefit vulnerable populations. However, successful implementation requires addressing gaps in regulatory oversight, pharmacists training, inter-professional collaboration, and public awareness. With proper regulatory frameworks, advocacy, enhanced training programs, public education, and establishment of well-designed database, PBV can achieve outcomes comparable to high-resource settings. This commentary aims to inform stakeholders and offer practical recommendations to minimize risks while leveraging its benefits.

Utilization of Immunization Information Systems (IIS) among independently owned community pharmacies: A national survey

BACKGROUND/OBJECTIVE

Immunization information systems (IIS) consolidate provider-submitted immunization information. We reassessed independently owned community pharmacies' IIS enrollment, verification of immunizations needs via IIS records retrieval, and immunization records reporting to IISs following post-pandemic shifts in community pharmacy operations.

METHODS

A cross-sectional online survey of National Community Pharmacists Association pharmacist, pharmacy owner, and pharmacy technician members was conducted in Fall 2022.

RESULTS

202 complete responses were analyzed. Margin of error was an estimated 7 %. Respondents were: 53.2 % female, ∼87 % White, 69.8 % managers, and 86.1 % practicing in standalone community pharmacies. Almost all (91.6 %) were enrolled in IIS. About two-thirds frequently or always utilized IIS to retrieve immunization records prior to immunization. On average, 81.2 % of influenza and 83.5 % of non-COVID/non-influenza vaccination records were submitted.

CONCLUSIONS

Enrollment rates are high among studied pharmacies, as are records reporting rates. However, records retrieval rates are suboptimal. Future work should focus on addressing suboptimal retrieval rates within immunization-providing pharmacies.

Evaluation of technician immunization administration

OBJECTIVES

To (1) assess technician and supervising pharmacists' attitudes and perceptions toward technicians administering immunizations after a technician training initiative, (2) describe the public health impact of technician-administered COVID-19 immunizations, and (3) describe best practices for technician-administered immunizations.

DESIGN

A mixed-methods study collected quantitative and qualitative data.

SETTING AND PARTICIPANTS

Kentucky technicians who completed an immunization administration training, and their supervising pharmacists.

OUTCOME MEASURES

Surveys were administered to Kentucky technicians who completed immunization administration training between January and September 2021. Surveys assessed the effectiveness of the training, integration of technicians in the immunization workflow, and impact of technicians in their organization's immunization efforts. Similar surveys were deployed to supervising pharmacists. Response frequencies were recorded for each question and descriptive statistics were calculated for each item included in the survey. Key informant interviews were conducted with technicians and pharmacists to further explore study concepts, assess needs, and discuss best practices for implementation. Interviews were audio recorded, transcribed verbatim, and analyzed using inductive thematic analysis.

RESULTS

Fifty-seven technicians and 37 pharmacists responded to the survey. Technicians were easily integrated into community pharmacy immunization workflow that allowed for increased immunization administration. Ninety-four percent of supervising pharmacists and 98% of technicians supported the use of technicians in the immunization workflow beyond the pandemic. Twenty-seven interviews were conducted. Major themes that emerged from the data included using the "right" technicians, role delineation and collaboration, policies, logistics, financial implications, and public health impact.

CONCLUSION

The utilization of pharmacy technicians in administration helped to accelerate the immunization process, alleviate the burden on pharmacists and other health care professionals, and ensure widespread vaccine distribution to combat the pandemic.