Despite concerns among PCPs, pharmacists have an ‘important role’ in vaccination
In a recent survey, most primary care physicians said it is helpful to have pharmacists administer vaccines to adults.
However, the survey also revealed concerns, including a lack of communication between PCPs and pharmacists, according to Christine Ellis MacBrayne, PharmD, MSCS, BCIDP, an infectious disease and antimicrobial stewardship clinical pharmacist at Children's Hospital Colorado, and colleagues.
Writing in the Journal of the American Board of Family Medicine, the researchers noted that pharmacists in all 50 states have been permitted to vaccinate adults since 2009.
“We know that pharmacists play an important role as immunizing providers,” MacBrayne told Healio Primary Care. “We wanted to understand more how PCPs and pharmacists can work together for optimal vaccine delivery.”
From January to February 2019, the researchers administered a survey to 926 members of ACP and the American Academy of Family Physicians. The survey utilized four-point Likert scales to ascertain physicians’ agreement with statements regarding the role of pharmacists in vaccination.
Of the 642 physicians who answered the survey, 364 were general internal medicine physicians and 278 were family practitioners. On average, the respondents tended to be younger and “had a larger median number of providers in their practice,” according to the researchers.
The survey showed that 79% of respondents “strongly agreed” and 19% “somewhat agreed” that the burden is on them to ensure their adult patients receive recommended vaccinations; 33% strongly agreed and 45% somewhat agreed that pharmacists did not have access to patient’s medical history; and 33% strongly agreed and 41% somewhat agreed that pharmacists had inadequate patient vaccination information.
Also, 35% of respondents strongly agreed and 39% somewhat agreed that pharmacists did not notify them when vaccinations were administered, and 20% strongly agreed and 37% somewhat agreed that pharmacists did not enter patients’ vaccination information into immunization information systems (IIS). Still, 31% strongly agreed and 52% somewhat agreed that having pharmacists assist in patients’ vaccination responsibilities is helpful.
Overall, MacBrayne said the findings are “really positive.”
“The surprising results from this research were the mixed responses regarding physicians’ comfort level with pharmacists’ access to patients’ medical and vaccination history as well as physicians’ concerns about pharmacists communicating receipt of vaccination to the patients’ medical home,” MacBrayne said. “These results shed light on the important role pharmacists play in providing immunizations, while also highlighting areas where a more coordinated approach to communication is needed.”
Perspective
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Had this study been done 10 years ago, the results would have been different. However, over the past decade, pharmacists have become much more involved in the immunization process.
This study has demonstrated that we really need to improve communication among members of a patient’s health care team by enhancing the use of the state-based IIS. Unfortunately, many states’ IISs have focused on pediatric immunization more than on adults. From what I understand, some states do not authorize pharmacists to enter a patient’s vaccine information into IIS. Furthermore, the state systems do not talk to each other. We need a more comprehensive system because adults do not stay in one place; they often travel and receive medical care in more than one state.
The whole purpose of IIS is to have a place where any provider in any location can access their patient's immunization record. The uncertainty of this information is a barrier to expanding adult immunizations. Very often, if the health care provider cannot readily find vaccine information, they will not vaccinate, because they do not wish to “over vaccinate” the patient.
All these points are highlighted in this illuminating study by MacBrayne and colleagues.
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