Primary Care Physicians' Perspective on Pharmacists Delivering Vaccines to Adults

Christine E. MacBrayne, PharmD, MSCS; Laura P. Hurley, MD, MPH; Sean T. O'Leary, MD, MPH; Jessica R. Cataldi, MD, MSCS; Lori A. Crane, PhD, MPH; Carol Gorman, BA; Michaela Brtnikova, PhD, MPH; Brenda L. Beaty, MSPH; Allison Kempe, MD, MPH

Disclosures

J Am Board Fam Med. 2021;34(2):392-397. 

In This Article

Abstract and Introduction

Abstract

Introduction: Since 2009, pharmacists in all 50 states have been authorized to provide vaccinations to adults. The objective of this study was to assess primary care physicians' (PCPs) experiences with and attitudes about pharmacists administering vaccinations.

Methods: Internet and mail survey of PCPs representative of American College of Physicians' and American Academy of Family Physicians' memberships.

Results: Response rate was 69% (642/926). Ninety-eight percent of respondents agreed (79% "Strongly," 19% "Somewhat") that it is their responsibility to assure their adult patients receive recommended vaccinations. Most respondents agreed that pharmacists either did not have access to patient medical information (33% "Strongly," 45% "Somewhat") or did not have adequate vaccination history (33% "Strongly," 41% "Somewhat"). The majority also agreed that pharmacists did not inform them when vaccinations were given (35% "Strongly," 39% "Somewhat") and did not enter vaccinations administered into immunization information systems (IISs) (20% "Strongly," 37% "Somewhat"). However, 83% agreed (31% "Strongly," 52% "Somewhat") that it is helpful to have pharmacists share the role of vaccinating adults.

Conclusions: PCPs have mixed feelings about pharmacists delivering vaccines. Universal use of IISs by pharmacists could partially address physicians' concerns by providing a systematic way for pharmacists and physicians to share patient vaccination histories.

Introduction

Adult vaccinations have proven effective at preventing morbidity and mortality as well as protecting the community from vaccine-preventable diseases, yet vaccines for adults are underused.[1] Vaccinations have traditionally been delivered in physician practices, hospitals, and public health systems. Pharmacists administering vaccinations has been a rapidly growing practice since the 1990s. Since 2009, pharmacists in all 50 states have been authorized to provide vaccinations, and during the 2014 to 2015 influenza season, 22% of adults received a vaccination at a retail pharmacy.[2–4]

As more pharmacists deliver vaccinations, there has been increased discussion surrounding the pharmacist's role in administering vaccinations, including dialog around how receipt of a vaccination in a pharmacy would affect the patient's "medical home."[4] In 2007, the "Joint Principles of the Patient-Centered Medical Home" was issued, outlining an approach to provide comprehensive primary care for children, youth, and adults. These principles outline the importance of the use of information technology and communication for coordinated care across all disciplines within the complex health care system.[5] To address the concerns of how vaccinations received in a pharmacy would affect the integrity of the patient's "medical home," the National Vaccine Advisory Committee (NVAC) published "Standards for Adult Immunization Practice" that highlighted the critical role that all vaccine providers have in improving vaccination coverage as well as documenting receipt of vaccination.[6] The American Pharmacist Association coined the term "immunization neighborhood" outlining a collaborative approach to providing vaccinations.[4,6,7] Pharmacists have an important role in providing vaccinations to adults due to several vaccines being covered by Medicare Part D, a pharmaceutical benefit; therefore, they can play a large role in establishing an immunization neighborhood. Thus, understanding primary care physicians' (PCPs) perceptions and experience with pharmacists administering vaccinations is a fundamental next step for furthering this relationship.[7]

This study aimed to assess PCPs' experience with and attitudes about pharmacists administering vaccinations to their adult patients.

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