Pharmacy Technician-Administered Vaccines: On Perceptions and Practice Reality

Doucette and Schommer recently surveyed U.S. community pharmacy technicians on their willingness to perform tasks including the administration of vaccines. They found that 47.1% of technicians reported they were “unwilling” to administer a vaccine, although this finding must be placed into proper context. The first nationwide survey of U.S. pharmacist perceptions on immunizations in 1998 revealed only 2.2% of pharmacist respondents had administered adult vaccines and only 0.9% had administered childhood vaccines. They also found pharmacists to be “slightly negative on administering immunizations” with many perceived barriers. Nonetheless, pharmacist-provided immunizations have been an unqualified public health success. The theory of planned behavior (TPB) predicts intention from attitude and perceived behavioral control, among other factors. Given low involvement, exposure, and perceived behavioral control to administer vaccinations, technicians’ attitudes or willingness to participate from the Doucette and Shommer study can be regarded as quite positive. Given the results of a successful pilot project in Idaho and that subjective norms and perceived behavioral control will likely shift upward, one can only expect technicians’ willingness to participate in vaccinations to become more favorable and ultimately become a success

The role of community pharmacies in the HIV and HCV care continuum

Introduction: In 2019, there were over 1.1 million people living with human immunodeficiency virus (HIV) and 2.4 million people living with hepatitis C virus (HCV) in the United States. One in seven (14%) are unaware of their HIV infection and almost half of all HCV infections are undiagnosed. People with unstable housing are disproportionately affected by HIV and HCV. The present study will evaluate interventions by community pharmacists that may reduce HIV and HCV transmission and promote linkage to care. Methods: This study was conducted in an independent community pharmacy in Spokane, Washington. Eligible study participants were walk-in patients of the pharmacy, over the age of 18, and experiencing homelessness. Pharmacy patients were excluded if they had a history of HIV or HCV diagnosis, received a screening for HIV or HCV in the last six months or were unable to give informed consent. The intervention included administration of HIV and HCV point-of-care testing (POCT) using a blood sample, risk determination interview, comprehensive HIV and HCV education, and personalized post-test and risk mitigation counseling followed by referral to partnering health clinics. Results: Fifty participants were included in the final data analysis. Twenty-two participants (44%) had a reactive HCV POCT, and one participant had a reactive HIV POCT. Of the 94% of participants who reported illicit drug use, 74% reported injection drug use. Seventy-six percent (n = 38) qualified for PrEP. Pharmacist referrals were made for 28 participants and 71% were confirmed to have established care. Conclusion: Individuals experiencing homelessness are at an increased risk for acquiring HIV and HCV due to risky sexual behaviors and substance misuse. PrEP is underutilized in the U.S. and pharmacist involvement in the HIV and HCV care continuum may have a significant impact in improving linkage and retention in care of difficult to treat populations

The Value and Potential Integration of Pharmacy Technician National Certification into Processes That Help Assure a Competent Workforce

The purposes of this study were: (1) to determine pharmacists’ perceptions of the impact of certification on competence in specific job skills, its impact in combination with job experience, and its impact in combination with other types of vocational education/training; (2) to identify elements that could potentially enhance the value, or impact of national certification; and (3) to determine how pharmacists view certification in light of various personnel management and organizational behavior phenomena. A self-administered survey was constructed and delivered in spring of 2019 to a random sample of four U.S. states chosen for their geographic diversity and relatively high proportions of both certified and non-certified pharmacy technicians. Following multiple reminders, a response rate of 19.3% was obtained. The 326 responding pharmacists saw certification being less impactful alone than when combined with other types of education/training and previous job experiences. They saw the need for more skills-related and “soft skills” content on the certification examination and agreed that certification is a factor in hiring decisions and that it should be required for designation for advanced practice status. Taken together, respondents saw the need for pharmacy leaders to integrate certification with other aspects of preparation to make for a more competent and professional workforce support team

Respecting the Patient’s Choice: A Case of Possible Drug-Induced Parkinsonism

This report describes a case of likely drug-induced Parkinsonism (DIP) identified by the pharmacist. A 54-year-old female patient was referred by a physician to the pharmacist in a rural, integrated care team for a comprehensive medication review (CMR) to address the patient’s concerns of possible Parkinson’s disease (PD). While PD may occur over the progression of age, medications that affect dopamine transport can also cause DIP, a secondary form of Parkinson’s disease. Although PD and DIP may be clinically indistinguishable, differentiation may be possible by reviewing a patient’s medication history for any potential causative drugs correlating to the timeline of the onset of symptoms. In this case, the pharmacist reviewed the medication profile and identified medications that could be responsible for causing DIP, specifically bupropion. The pharmacist suggested discontinuing bupropion and identifying another option for treating depression. The patient appreciated the suggestion and education, but ultimately preferred continuing her bupropion therapy instead of discontinuing therapy or changing to an alternative agent. At a follow-up meeting with the pharmacist, not only was the patient still experiencing tremors despite taking carbidopa/levodopa, but additional medications known to be potential inducers of tremors were added to her regimen. Although the pharmacist repeatedly discussed DIP with the patient and believed stopping bupropion would determine whether her Parkinsonism was PD or DIP, ultimately the patient continued taking bupropion because of concerns related to depression severity and the impact on her well-being. The patient’s wishes were respected

Pharmacy Technician-Administered Vaccines: On Perceptions and Practice Reality

Doucette and Schommer recently surveyed U.S. community pharmacy technicians on their willingness to perform tasks including the administration of vaccines. They found that 47.1% of technicians reported they were “unwilling„ to administer a vaccine, although this finding must be placed into proper context. The first nationwide survey of U.S. pharmacist perceptions on immunizations in 1998 revealed only 2.2% of pharmacist respondents had administered adult vaccines and only 0.9% had administered childhood vaccines. They also found pharmacists to be “slightly negative on administering immunizations„ with many perceived barriers. Nonetheless, pharmacist-provided immunizations have been an unqualified public health success. The theory of planned behavior (TPB) predicts intention from attitude and perceived behavioral control, among other factors. Given low involvement, exposure, and perceived behavioral control to administer vaccinations, technicians’ attitudes or willingness to participate from the Doucette and Shommer study can be regarded as quite positive. Given the results of a successful pilot project in Idaho and that subjective norms and perceived behavioral control will likely shift upward, one can only expect technicians’ willingness to participate in vaccinations to become more favorable and ultimately become a success

A Pharmacist’s Role in a Case of Allergy Labeling and Acute Bacterial Rhinosinusitis Treatment

This case report describes a pharmacist’s intervention with a 58-year-old female who presented with recurrent rhinosinusitis symptoms and limited treatment options due to a complicated allergy history. Using guidelines for treatment of acute bacterial rhinosinusitis coupled with a thorough antibiotic allergy assessment, the pharmacist developed a treatment plan that was acceptable to both the patient and the provider. Pharmacists can play an essential role in verification of allergies to both medications and non-pharmaceutical products, which further ensures patient safety as well as optimization of appropriate treatment methods

The impact of a mental health course elective on student pharmacist attitudes.

BACKGROUND AND PURPOSE: A mental health first aid elective course was developed at a four-year doctor of pharmacy program. The objectives of the course were to de-stigmatize the attitudes of enrolled student pharmacists and provide tools to triage and manage mental health crises. The purpose of this work is to investigate the impact of a newly developed mental health first aid elective course. EDUCATIONAL ACTIVITY AND SETTING: Student pharmacists enrolled in a two-credit mental health first aid elective course and electronically completed the Opening Minds Scale for Health Care Providers (OMS-HC) pre-course, post-course, and months post-course to quantitatively measure changes in attitudes around stigma in various domains. Students also submitted a guided reflection post-course to collect self-perceived changes in attitudes. The reflection evaluated the changes in perceptions, confidence, and willingness to practice mental health first aid. FINDINGS: Forty-second and third-year student pharmacists participated and 31 were included in the pre-protocol analysis for pre- and post-course paired comparisons. Improvements in the OMS-HC domains of disclosure and help-seeking and attitudes of health care providers at post-course were observed. Self-reflections submitted post-course supported the quantitative analysis results of the OMS-HC scores. Improvements were noted in attitudes towards individuals with mental health disorders and in confidence and willingness to initiate conversations on mental health. SUMMARY: The implementation of a mental health first aid elective course positively influenced student pharmacists\u27 attitudes on mental health and improved confidence and willingness to provide mental health related interventions