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

Evaluating the role and integration of general practice pharmacists in England:a cross-sectional study

Background Since 2015, NHS England has facilitated the recruitment of pharmacists in general practice (GP) to reduce workload of general practitioners. The role of pharmacists is therefore expected to become more clinical and patient oriented. However, little is known about the current roles performed and the integration of GP pharmacists. Objective To assess the role performed by GP pharmacists and their integration into practice exploring facilitators and barriers to integration. Setting A cross-sectional survey of GP pharmacists in England. Method This study used both online and paper-based questionnaires for a period of six months. Survey items included demographics, roles performed, integration including available support and practice environment. Quantitative data were analysed using descriptive statistics and 95% confidence intervals. Open comments were analysed thematically to identify pharmacists’ perceptions of barriers and facilitators to their integration into practice. Main outcome measure Current role and integration of pharmacists into GP. Results 195 participants completed the questionnaire. Three quarters of pharmacists (76%) had only been in GP since 2015. Most pharmacists (81%) were independent prescribers (PIPs). The most reported pharmacists’ roles were medicine reconciliation (95%), telephone support for patients (95%) and face-to-face medication review (91%). 82% (95% CI: 76% to 86.8%) were satisfied with their overall integration into practice. Half of pharmacists (45%) were working in a shared office or at a hot desk and 9% had no designated workspace. PIPs had more access to a convenient workplace (p = 0.016) compared to non-IPs. Conclusion Practice pharmacists are fulfilling a wide range of clinical and non-clinical roles in England. Findings highlight relatively a satisfactory level of pharmacists’ integration into practice and shed the light on their integration issues. These findings could be significant for the development of future roles of pharmacists in GP

Community pharmacy advanced adherence services for children and young people with long-term conditions:a cross-sectional survey study

Objective: The aim of this study was to investigate the provision of community pharmacy services to children and young people with a focus on advanced services such as medicines use review. Perceptions and experiences of community pharmacists, pharmacy staff, young people and their parents or carers on the provision of such services were also explored. Methods: Four different cross-sectional, self-administered questionnaires were distributed in parallel to pharmacists, pharmacy staff members, children and young people and parents in the United Kingdom. Results: An outline of pharmacist’s current involvement with children and young people was provided by 92 pharmacists. A different group of 38 community pharmacists and 40 non-pharmacist members of pharmacy staff from a total of 46 pharmacies provided information and views on the conduct of Medicines use review with children and young people. Experiences of advanced pharmacy service provision were collected from 51 children and young people and 18 parents. Most pharmacists offered public health advice to children and young people (73/92; 79.3%) and even more (83/92; 90.2%) reported that they often interacted with children and young people with long-term condition. Despite their high levels of interaction, and a majority opinion that medicines use reviews could benefit children (35/38; 92.1%), the number of pharmacies reporting to have conducted medicines use reviews with children was low (5/41). Pharmacists perceived the main barriers to recruitment as consent (17/29; 58.6%), guideline ambiguity (14/29; 48.3%) and training (13/29; 44.8%). A considerable proportion pharmacists (12/29; 41.4%) and other personnel (14/33; 42.4%) working in community pharmacies were unaware that children were potentially eligible for medicines use reviews. Only 29.4% of the 51 children and young people participants had received advice about their long-term condition from a pharmacist and the majority (46/51; 90.2%) had not taken part in an advanced service focused on adherence. Conclusions: While general engagement with children and young people appears high from the pharmacist’s perspective, advice specific to children and young people with long-term conditions and the provision of advanced services in this group remains a challenge

Evaluation of channels for angiogenic cells ingrowth in collagen scaffolds in vitro and in vivo

Pre-cellularised scaffolds are limited in volume due to the constraints of the time delay required for angiogenic cells ingrowth forming a vascular network and allowing for delivery of nutrients and waste exchange. Channels have the potential to improve the time taken for cellular penetration. The effectiveness of channels in improving angiogenic cells penetration was assessed in vitro and in vivo in porous 3-D collagen scaffolds. Initial studies conducted in vitro demonstrated that the scaffolds supported angiogenic cells ingrowth in culture and the channels improved the depth of penetration of cells into the scaffold. The cells reside mainly around the channels and migrate along the channels. In vivo, channels increased cell migration into the scaffolds and in particular angiogenic cells resulting in a clear branched vascular network of micro vessels in the channelled samples which was not apparent in the non-channelled samples. This correlated well with macrophage invasion into scaffolds since angiogenesis in vivo is usually accompanied by infiltration of macrophages which participate in organization of angiogenesis, and in regulation of tissue regeneration. Thus, macrophage-mediated biodegradation of collagen scaffolds in vitro was also assessed. Furthermore, pre-seeding channelled collagen scaffolds with endothelial cells implantation has potential of speeding up vascularisation of scaffolds compared to human bone marrow stromal cells

Evaluation of channels for angiogenic cells ingrowth in collagen scaffolds in vitro and in vivo

Pre-cellularised scaffolds are limited in volume due to the constraints of the time delay required for angiogenic cells ingrowth forming a vascular network and allowing for delivery of nutrients and waste exchange. Channels have the potential to improve the time taken for cellular penetration. The effectiveness of channels in improving angiogenic cells penetration was assessed in vitro and in vivo in porous 3-D collagen scaffolds. Initial studies conducted in vitro demonstrated that the scaffolds supported angiogenic cells ingrowth in culture and the channels improved the depth of penetration of cells into the scaffold. The cells reside mainly around the channels and migrate along the channels. In vivo, channels increased cell migration into the scaffolds and in particular angiogenic cells resulting in a clear branched vascular network of micro vessels in the channelled samples which was not apparent in the non-channelled samples. This correlated well with macrophage invasion into scaffolds since angiogenesis in vivo is usually accompanied by infiltration of macrophages which participate in organization of angiogenesis, and in regulation of tissue regeneration. Thus, macrophage-mediated biodegradation of collagen scaffolds in vitro was also assessed. Furthermore, pre-seeding channelled collagen scaffolds with endothelial cells implantation has potential of speeding up vascularisation of scaffolds compared to human bone marrow stromal cells.</p