To describe the characteristics of pharmacist immunizers and pharmacist-based immunization services in North Carolina based on immunizing pharmacist survey responses and to identify barriers and challenges to pharmacist-based immunization services in North Carolina.
Descriptive, nonexperimental, cross-sectional study.
All pharmacists with an active pharmacist license in North Carolina in early 2007.
Settings in which pharmacist respondents practiced, types of immunization services offered, level of participation in immunization services, and perceptions of possible barriers and challenges to providing pharmacistbased immunization services.
1,274 (12.8%) responses were included in the final analysis. Approximately 22% of respondents (n = 286) had completed an immunization certificate training program. Of these respondents, more than half (n = 148) had administered vaccinations in the past year (active immunizers). The majority (52%) of active immunizers had been in practice for fewer than 10 years and worked in either community chain or independent pharmacies. Almost all respondents actively involved in administering immunizations offered inactivated influenza immunizations (95.9%). A smaller percentage of pharmacists (39.2%) offered pneumococcal vaccinations at their practice site. All respondents were likely to perceive time and area/space as barriers to providing immunization services; each group also had several distinct perceived barriers. Many factors were perceived as barriers to pharmacists' ability to provide care by active immunizers. The majority of active immunizers were willing to provide additional vaccine types.
This research has provided information about the number of pharmacists providing immunization services and characteristics of the services they provide. The demographics and settings of pharmacists in relationship to their engagement in immunization services are also provided. Last, the current work helps assess the perceived barriers to providing immunization services and pharmacist interest in expanded opportunities.
[Show abstract][Hide abstract] ABSTRACT: MEDICATION SAFETY Overlooked Renal Dosage Adjustments A retrospective analysis of 647 patients at hospital discharge com-pared required renal dosage adjust-ments to dosage actually prescribed. This study was conducted at VieCuri Medical Centre in Venlo, Netherlands. Patient demographics and renal function data were col-lected, and dosage adjustment needs were assessed via the pharmacy-supported discharge counseling ser-vice. The incidence of inappropriate dosing based on renal function was measured at hospital discharge. Thirty-seven percent of patients evaluated during the study period (237/647) had a creatinine clear-ance less than 51 mL/min/1.73 m 2 ; dosage adjustment was warranted in 23.9% (411/1,718) of prescrip-tions. When dosage adjustment should have been performed, more than 40% of prescriptions (169/411; 41.1%) were inappropri-ate for renal function (9.8% of pre-scriptions overall; 169/1,718). Fur-thermore, 60.4% (102/169) of inappropriate prescriptions pos-sessed the potential for moderate or severe clinical consequences, as evaluated by a panel of two clinical pharmacologists and one nephrolo-gist. Study authors also noted a lack of standardized dosing guidelines for agents requiring renal dosage adjustment. The authors also sug-gested that augmenting medication systems by adding dynamic renal dosing alerts would improve moni-toring. Summary: A comparison of suggested renal dosing and actual dosing at hospital discharge revealed that appropriate prescribing may be overlooked. van Dijk EA, Drabbe NRG, Kruijtbosch M, De Smet PAGM. Drug dosage adjust-ments according to renal function at hos-pital discharge. Ann Pharmacother. 2006;40:1254-1260.
[Show abstract][Hide abstract] ABSTRACT: To compare earlier (sustainers) and later (new) adopters in terms of pharmacy characteristics and characteristics of in-house vaccination services and to identify how sustainers modified their in-house vaccination services over time.
Nonexperimental multistage study.
Washington State during 2003, 2004, and 2006-2007.
Community pharmacies included in this study's analyses must have participated in all data collection stages and provided in-house vaccination services during the third stage. Based on key informants' self-reports, those who had provided in-house services before or since 2003 were sustainers and those who started their services after 2004 were new adopters.
Pharmacy characteristics and characteristics of in-house vaccination services offered in 2003 and 2006 were measured in terms of service accessibility, scope, and supportive personnel.
A total of 37 sustainers and 27 new adopters met the inclusion criteria. The majority of independent and supermarket pharmacies were sustainers, whereas the majority of chain and mass merchant pharmacies were new adopters. In-house services offered by sustainers were broader in service accessibility and scope and involved a greater number of pharmacists trained in immunization delivery than services offered by new adopters in the same year. Further, when comparing sustainers' in-house services offered in 2003 and 2006, the 2006 services were expanded to provide year-round services, involved a greater number of settings, included services to adolescents, and involved a greater number of trained pharmacists.
Community pharmacies started their in-house vaccination services on a small scale and later expanded to a larger scale. Pharmacies with expanded in-house services can make greater contributions to their business, their patients, and the profession by bringing in additional revenues, improving vaccination rates among high-risk patients, and facilitating the growth of pharmacy-based services.
Journal of the American Pharmacists Association 01/2010; 50(1):52-61. DOI:10.1331/JAPhA.2010.09036 · 1.24 Impact Factor
[Show abstract][Hide abstract] ABSTRACT: BACKGROUND: Substance abuse and addiction are growing public health problems. Pharmacists are potentially in a position to be of great assistance in ameliorating these threats yet might not be receiving the education and training to do so effectively. OBJECTIVE: To assess the relative perceived importance of substance abuse topics in pharmacy education among student pharmacists and pharmacy practitioners in the state of Indiana. METHODS: Questionnaires were administered in class to students at Purdue University College of Pharmacy and via direct mail to the home addresses of randomly selected licensed Indiana pharmacists in 2009 to elicit information on the relevance and interest for particular topics within addiction education, prior education received regarding addiction, and the frequency of professional interactions that involved addiction. RESULTS: Three hundred fifty students (74%) and 625 pharmacists (26%) responded to the survey. The average interest across all surveyed topics was 3.18/4.00 for students and 3.47/4.00 for practitioners. Areas rated highly by both groups included withdrawal, pain management, and recognition of signs and symptoms of addiction in patients. Qualitative responses from practitioners suggest strong interest in further education in this area and a perceived need for increased educational exposure during the student pharmacist experience. The average pharmacist respondent spent 6.94% of the time dealing with people who were addicted, and 22.2% had independent addiction education. CONCLUSIONS: Pharmacists and pharmacy student respondents overwhelmingly felt that educational preparation in this area is important. A significant portion of time in practice is spent managing addiction-related issues, and further educational opportunities are being pursued beyond graduation to fulfill the educational needs of the practitioner respondents.
Research in Social and Administrative Pharmacy 06/2012; 9(1). DOI:10.1016/j.sapharm.2012.03.003 · 2.35 Impact Factor
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