Pharmacists' and patients' attitudes towards vaccination in community pharmacy

Cijepljenje je neupitno jedno od najvećih dostignuća prošlog stoljeća te predstavlja najučinkovitiju javnozdravstvenu metodu u eradikaciji i sprječavanju širenja zaraznih bolesti. Iako su prednosti i dobrobiti cijepljenja dobro poznati i dalje je prisutan trend nedostatnog cjepnog obuhvata u cijepljenju protiv gripe. Procjena je da godišnje od težeg oblika gripe u svijetu oboli od 3 do 5 milijuna, od 290 do 650 tisuća osoba ne preživi ovu bolest dok u Europi oko 70 tisuća. Cijepljenje je u nekim zemljama svijeta alocirano i na ljekarnike u javnim ljekarnama koji su prepoznati kao važne i javnosti najdostupnije karike lanca primarne zdravstvene zaštite što se pozitivno odrazilo na cjepni obuhvat i položaj farmaceuta. Cilj ovog istraživanja bio je utvrditi stavove ljekarnika i pacijenata na području Hrvatske o potencijalnoj implementaciji cijepljenja u ljekarne te vrednovanje iste. Ova presječna studija provodila se od svibnja do srpnja 2021. godine. Upitnici su dizajnirani za studiju i kao takvi prvi puta korišteni. Likertovom skalom (1 - 5) ispitanici su mogli izraziti svoje stavove na navedene tvrdnje. U istraživanju je sudjelovalo 362 ljekarnika što je oko 13 % ukupnog broja ljekarnika zaposlenih u javnim ljekarnama. Uzorak su činili 86,7 % žena i 13,3 % muškaraca, a medijan dobi ispitanika bio je 36,0 [16,0] godina. Oko polovina ispitanika (55 %) smatra da cijepljenje treba biti omogućeno u ljekarnama. Uočena je značajna korelacija između stavova da se pacijentima treba osigurati cijepljenje u ljekarni i spremnosti na provođenje te usluge ( = 0,724, p < 0,01). Gotovo svi ljekarnici slažu se da ne bi cijepili bez edukacije, a nakon edukacije više od 60 % ljekarnika bi pristalo cijepiti pacijente. Preko 90 % ljekarnika slaže se da bi za tu uslugu trebala postojati odgovarajuća licenca koja bi se edukacijama i stručnim usavršavanjem periodički obnavljala. U istraživanju je sudjelovalo 367 pacijenata. Žene su činile 62,7 % , muškarci 37,3 % ispitanika. Medijan dobi ispitanika iznosio je 41,0 [26,0]. Ljekarnici i pacijenti procjenom vrijednosti usluge cijepljenja dali su istu medijalnu vrijednost od 50 kuna neovisno od toga tko istu financira. Kod pacijenata je uočen veći interkvartilni raspon i pomaknut prema većem iznosu (35 - 100) nego kod ljekarnika (20 - 70). Zaključno, gotovo svi uključeni ljekarnici imaju pozitivan stav prema cijepljenju općenito i gotovo dvije trećine ljekarnika spremno je cijepiti pacijente u ljekarni uz prethodnu edukaciju. S druge strane ne treba zanemariti činjenice da gotovo polovina ljekarnika nema pozitivan stav ili su neodlučni prema uvođenju cijepljenja kao usluge u ljekarnu te da oko trećina smatra da cijepljenje ne spada u ljekarničke kompetencije. Ovi rezultati upućuju na potrebu za raspravom unutar struke o ulozi ljekarnika, a koji je najdostupnijeg zdravstveni radnik, u cijepljenju.Vaccination is unquestionably one of the greatest achievements of the last century, representing the most effective public health method in eradicating and preventing the spread of infectious diseases. Although the benefits of vaccination are well known, there is still a trend of insufficient vaccination coverage in influenza vaccination. It is estimated that 3 to 5 million people worldwide get the most severe form of the flu, 290.000 to 650.000 people do not survive the disease, while in Europe about 70.000. Vaccination has been allocated in some countries around the world to community pharmacists who have been recognized as important and most available health care professionals which had a positive effect on the overall coverage and role of pharmacists. This research aimed to determine the attitudes of pharmacists and patients in Croatia about the potential implementation of vaccination in community pharmacies and to determine the value of the service. This cross-sectional study was conducted from May to July 2021. Questionnaires were designed for the study and as such was used for the first time. On the Likert scale (1 - 5), respondents were able to express their opinion on offered statements. 362 pharmacists participated in the study, which is about 13% of the total number of pharmacists employed in community pharmacies. The sample consisted of 86.7% women and 13.3% men, and the median of pharmacists' age was 36.0 [16.0] years. About half of the respondents (55%) believe that vaccination should be provided in pharmacies. A significant correlation was observed between the attitudes that the patient should be provided with vaccination in pharmacies and readiness to perform services ( = 0.724, p < 0.01). Almost all pharmacists agree that they would not vaccinate without education, and after education more than 60% of pharmacists think differently. Over 90% of pharmacists agree that there should be an appropriate license for this service, which should be periodically renewed through professional training. 367 patients participated in the study. The sample consisted of 62,7% women and 37,3%. The median of patients' age was 41.0 [26.0]. Pharmacists and patients estimated median value of vaccination services of HRK 50, regardless of who financed it. In patients, a larger interquartile range was observed and shifted to a larger amount (35 - 100) than in pharmacists (20 - 70). In conclusion, almost all pharmacists involved in this study have a positive attitude towards vaccination in general and almost two thirds of pharmacists are willing to vaccinate patients in the pharmacy with prior education. On the other hand, we should not ignore the fact that almost half of pharmacists do not have a positive attitude or are undecided about the introduction of vaccination as a service in the pharmacy and that about a third believe that vaccination does not fall within pharmacists’ competencies. These results suggest the need for discussion within the profession about the role of the pharmacist, who is the most accessible healthcare professional, in vaccination

Pharmacists' and patients' attitudes towards vaccination in community pharmacy

Cijepljenje je neupitno jedno od najvećih dostignuća prošlog stoljeća te predstavlja najučinkovitiju javnozdravstvenu metodu u eradikaciji i sprječavanju širenja zaraznih bolesti. Iako su prednosti i dobrobiti cijepljenja dobro poznati i dalje je prisutan trend nedostatnog cjepnog obuhvata u cijepljenju protiv gripe. Procjena je da godišnje od težeg oblika gripe u svijetu oboli od 3 do 5 milijuna, od 290 do 650 tisuća osoba ne preživi ovu bolest dok u Europi oko 70 tisuća. Cijepljenje je u nekim zemljama svijeta alocirano i na ljekarnike u javnim ljekarnama koji su prepoznati kao važne i javnosti najdostupnije karike lanca primarne zdravstvene zaštite što se pozitivno odrazilo na cjepni obuhvat i položaj farmaceuta. Cilj ovog istraživanja bio je utvrditi stavove ljekarnika i pacijenata na području Hrvatske o potencijalnoj implementaciji cijepljenja u ljekarne te vrednovanje iste. Ova presječna studija provodila se od svibnja do srpnja 2021. godine. Upitnici su dizajnirani za studiju i kao takvi prvi puta korišteni. Likertovom skalom (1 - 5) ispitanici su mogli izraziti svoje stavove na navedene tvrdnje. U istraživanju je sudjelovalo 362 ljekarnika što je oko 13 % ukupnog broja ljekarnika zaposlenih u javnim ljekarnama. Uzorak su činili 86,7 % žena i 13,3 % muškaraca, a medijan dobi ispitanika bio je 36,0 [16,0] godina. Oko polovina ispitanika (55 %) smatra da cijepljenje treba biti omogućeno u ljekarnama. Uočena je značajna korelacija između stavova da se pacijentima treba osigurati cijepljenje u ljekarni i spremnosti na provođenje te usluge ( = 0,724, p < 0,01). Gotovo svi ljekarnici slažu se da ne bi cijepili bez edukacije, a nakon edukacije više od 60 % ljekarnika bi pristalo cijepiti pacijente. Preko 90 % ljekarnika slaže se da bi za tu uslugu trebala postojati odgovarajuća licenca koja bi se edukacijama i stručnim usavršavanjem periodički obnavljala. U istraživanju je sudjelovalo 367 pacijenata. Žene su činile 62,7 % , muškarci 37,3 % ispitanika. Medijan dobi ispitanika iznosio je 41,0 [26,0]. Ljekarnici i pacijenti procjenom vrijednosti usluge cijepljenja dali su istu medijalnu vrijednost od 50 kuna neovisno od toga tko istu financira. Kod pacijenata je uočen veći interkvartilni raspon i pomaknut prema većem iznosu (35 - 100) nego kod ljekarnika (20 - 70). Zaključno, gotovo svi uključeni ljekarnici imaju pozitivan stav prema cijepljenju općenito i gotovo dvije trećine ljekarnika spremno je cijepiti pacijente u ljekarni uz prethodnu edukaciju. S druge strane ne treba zanemariti činjenice da gotovo polovina ljekarnika nema pozitivan stav ili su neodlučni prema uvođenju cijepljenja kao usluge u ljekarnu te da oko trećina smatra da cijepljenje ne spada u ljekarničke kompetencije. Ovi rezultati upućuju na potrebu za raspravom unutar struke o ulozi ljekarnika, a koji je najdostupnijeg zdravstveni radnik, u cijepljenju.Vaccination is unquestionably one of the greatest achievements of the last century, representing the most effective public health method in eradicating and preventing the spread of infectious diseases. Although the benefits of vaccination are well known, there is still a trend of insufficient vaccination coverage in influenza vaccination. It is estimated that 3 to 5 million people worldwide get the most severe form of the flu, 290.000 to 650.000 people do not survive the disease, while in Europe about 70.000. Vaccination has been allocated in some countries around the world to community pharmacists who have been recognized as important and most available health care professionals which had a positive effect on the overall coverage and role of pharmacists. This research aimed to determine the attitudes of pharmacists and patients in Croatia about the potential implementation of vaccination in community pharmacies and to determine the value of the service. This cross-sectional study was conducted from May to July 2021. Questionnaires were designed for the study and as such was used for the first time. On the Likert scale (1 - 5), respondents were able to express their opinion on offered statements. 362 pharmacists participated in the study, which is about 13% of the total number of pharmacists employed in community pharmacies. The sample consisted of 86.7% women and 13.3% men, and the median of pharmacists' age was 36.0 [16.0] years. About half of the respondents (55%) believe that vaccination should be provided in pharmacies. A significant correlation was observed between the attitudes that the patient should be provided with vaccination in pharmacies and readiness to perform services ( = 0.724, p < 0.01). Almost all pharmacists agree that they would not vaccinate without education, and after education more than 60% of pharmacists think differently. Over 90% of pharmacists agree that there should be an appropriate license for this service, which should be periodically renewed through professional training. 367 patients participated in the study. The sample consisted of 62,7% women and 37,3%. The median of patients' age was 41.0 [26.0]. Pharmacists and patients estimated median value of vaccination services of HRK 50, regardless of who financed it. In patients, a larger interquartile range was observed and shifted to a larger amount (35 - 100) than in pharmacists (20 - 70). In conclusion, almost all pharmacists involved in this study have a positive attitude towards vaccination in general and almost two thirds of pharmacists are willing to vaccinate patients in the pharmacy with prior education. On the other hand, we should not ignore the fact that almost half of pharmacists do not have a positive attitude or are undecided about the introduction of vaccination as a service in the pharmacy and that about a third believe that vaccination does not fall within pharmacists’ competencies. These results suggest the need for discussion within the profession about the role of the pharmacist, who is the most accessible healthcare professional, in vaccination

Pharmacists' and patients' attitudes towards vaccination in community pharmacy

Cijepljenje je neupitno jedno od najvećih dostignuća prošlog stoljeća te predstavlja najučinkovitiju javnozdravstvenu metodu u eradikaciji i sprječavanju širenja zaraznih bolesti. Iako su prednosti i dobrobiti cijepljenja dobro poznati i dalje je prisutan trend nedostatnog cjepnog obuhvata u cijepljenju protiv gripe. Procjena je da godišnje od težeg oblika gripe u svijetu oboli od 3 do 5 milijuna, od 290 do 650 tisuća osoba ne preživi ovu bolest dok u Europi oko 70 tisuća. Cijepljenje je u nekim zemljama svijeta alocirano i na ljekarnike u javnim ljekarnama koji su prepoznati kao važne i javnosti najdostupnije karike lanca primarne zdravstvene zaštite što se pozitivno odrazilo na cjepni obuhvat i položaj farmaceuta. Cilj ovog istraživanja bio je utvrditi stavove ljekarnika i pacijenata na području Hrvatske o potencijalnoj implementaciji cijepljenja u ljekarne te vrednovanje iste. Ova presječna studija provodila se od svibnja do srpnja 2021. godine. Upitnici su dizajnirani za studiju i kao takvi prvi puta korišteni. Likertovom skalom (1 - 5) ispitanici su mogli izraziti svoje stavove na navedene tvrdnje. U istraživanju je sudjelovalo 362 ljekarnika što je oko 13 % ukupnog broja ljekarnika zaposlenih u javnim ljekarnama. Uzorak su činili 86,7 % žena i 13,3 % muškaraca, a medijan dobi ispitanika bio je 36,0 [16,0] godina. Oko polovina ispitanika (55 %) smatra da cijepljenje treba biti omogućeno u ljekarnama. Uočena je značajna korelacija između stavova da se pacijentima treba osigurati cijepljenje u ljekarni i spremnosti na provođenje te usluge ( = 0,724, p < 0,01). Gotovo svi ljekarnici slažu se da ne bi cijepili bez edukacije, a nakon edukacije više od 60 % ljekarnika bi pristalo cijepiti pacijente. Preko 90 % ljekarnika slaže se da bi za tu uslugu trebala postojati odgovarajuća licenca koja bi se edukacijama i stručnim usavršavanjem periodički obnavljala. U istraživanju je sudjelovalo 367 pacijenata. Žene su činile 62,7 % , muškarci 37,3 % ispitanika. Medijan dobi ispitanika iznosio je 41,0 [26,0]. Ljekarnici i pacijenti procjenom vrijednosti usluge cijepljenja dali su istu medijalnu vrijednost od 50 kuna neovisno od toga tko istu financira. Kod pacijenata je uočen veći interkvartilni raspon i pomaknut prema većem iznosu (35 - 100) nego kod ljekarnika (20 - 70). Zaključno, gotovo svi uključeni ljekarnici imaju pozitivan stav prema cijepljenju općenito i gotovo dvije trećine ljekarnika spremno je cijepiti pacijente u ljekarni uz prethodnu edukaciju. S druge strane ne treba zanemariti činjenice da gotovo polovina ljekarnika nema pozitivan stav ili su neodlučni prema uvođenju cijepljenja kao usluge u ljekarnu te da oko trećina smatra da cijepljenje ne spada u ljekarničke kompetencije. Ovi rezultati upućuju na potrebu za raspravom unutar struke o ulozi ljekarnika, a koji je najdostupnijeg zdravstveni radnik, u cijepljenju.Vaccination is unquestionably one of the greatest achievements of the last century, representing the most effective public health method in eradicating and preventing the spread of infectious diseases. Although the benefits of vaccination are well known, there is still a trend of insufficient vaccination coverage in influenza vaccination. It is estimated that 3 to 5 million people worldwide get the most severe form of the flu, 290.000 to 650.000 people do not survive the disease, while in Europe about 70.000. Vaccination has been allocated in some countries around the world to community pharmacists who have been recognized as important and most available health care professionals which had a positive effect on the overall coverage and role of pharmacists. This research aimed to determine the attitudes of pharmacists and patients in Croatia about the potential implementation of vaccination in community pharmacies and to determine the value of the service. This cross-sectional study was conducted from May to July 2021. Questionnaires were designed for the study and as such was used for the first time. On the Likert scale (1 - 5), respondents were able to express their opinion on offered statements. 362 pharmacists participated in the study, which is about 13% of the total number of pharmacists employed in community pharmacies. The sample consisted of 86.7% women and 13.3% men, and the median of pharmacists' age was 36.0 [16.0] years. About half of the respondents (55%) believe that vaccination should be provided in pharmacies. A significant correlation was observed between the attitudes that the patient should be provided with vaccination in pharmacies and readiness to perform services ( = 0.724, p < 0.01). Almost all pharmacists agree that they would not vaccinate without education, and after education more than 60% of pharmacists think differently. Over 90% of pharmacists agree that there should be an appropriate license for this service, which should be periodically renewed through professional training. 367 patients participated in the study. The sample consisted of 62,7% women and 37,3%. The median of patients' age was 41.0 [26.0]. Pharmacists and patients estimated median value of vaccination services of HRK 50, regardless of who financed it. In patients, a larger interquartile range was observed and shifted to a larger amount (35 - 100) than in pharmacists (20 - 70). In conclusion, almost all pharmacists involved in this study have a positive attitude towards vaccination in general and almost two thirds of pharmacists are willing to vaccinate patients in the pharmacy with prior education. On the other hand, we should not ignore the fact that almost half of pharmacists do not have a positive attitude or are undecided about the introduction of vaccination as a service in the pharmacy and that about a third believe that vaccination does not fall within pharmacists’ competencies. These results suggest the need for discussion within the profession about the role of the pharmacist, who is the most accessible healthcare professional, in vaccination

Clinical decision-making in benzodiazepine deprescribing by healthcare providers vs. AI-assisted approach

Aims: The aim of this study was to compare the clinical decision-making for benzodiazepine deprescribing between a healthcare provider (HCP) and an artificial intelligence (AI) chatbot GPT4 (ChatGPT-4). Methods: We analysed real-world data from a Croatian cohort of community-dwelling benzodiazepine patients (n = 154) within the EuroAgeism H2020 ESR 7 project. HCPs evaluated the data using pre-established deprescribing criteria to assess benzodiazepine discontinuation potential. The research team devised and tested AI prompts to ensure consistency with HCP judgements. An independent researcher employed ChatGPT-4 with predetermined prompts to simulate clinical decisions for each patient case. Data derived from human-HCP and ChatGPT-4 decisions were compared for agreement rates and Cohen's kappa. Results : Both HPC and ChatGPT identified patients for benzodiazepine deprescribing (96.1% and 89.6%, respectively), showing an agreement rate of 95% (κ=.200,P=.012). Agreement on four deprescribing criteria ranged from 74.7% to 91.3%(lack of indicationκ=.352,P< .001; prolonged useκ=.088,P=.280; safety concernsκ=.123,P=.006; incorrect dosageκ=.264,P=.001). Important limitationsof GPT-4 responses were identified, including 22.1% ambiguous outputs, genericanswers and inaccuracies, posing inappropriate decision-making risks.Conclusions : While AI-HCP agreement is substantial, sole AI reliance poses a risk forunsuitable clinical decision-making. This study's findings reveal both strengths andareas for enhancement of ChatGPT-4 in the deprescribing recommendations within areal-world sample. Our study underscores the need for additional research on chatbot functionality in patient therapy decision-making, further fostering the advance-ment of AI for optimal performance