A retrospective review of the impact of immunization eCare plans in community-based pharmacy setting.

BACKGROUND: The Pharmacist Electronic Care (eCare) plan is an electronic documentation and billing platform that allows for exchanging and integrating pharmacy patient care information. eCare plans make it easier for pharmacists to track recommendations and referrals to both patients and providers and to bill for services. OBJECTIVES: To determine the impact on the type and number of vaccines administered after the completion of immunization eCare plans and to examine sociodemographic differences in patients who received immunizations were documented in an eCare plan in a community-based pharmacy setting. PRACTICE DESCRIPTION: Bremo Pharmacy is an independently owned pharmacy located in Richmond, Virginia. Bremo Pharmacy offers a medication synchronization program targeting patients for enrollment in compliance packaging and clinical services. PRACTICE INNOVATION: Bremo Pharmacists use eCare plans to track patient and provider interactions, goals, and medication-related information. Pharmacists used eCare plans to document vaccine recommendations and interactions with patients as a tool to increase vaccinations. EVALUATION METHODS: Reports were generated to extract data containing information from each eCare plan during the intervention period and the number and type of vaccines administered 1 and 2 years before the intervention. Percent change was used to calculate the change in vaccines administered between years. The sociodemographic data was analyzed using descriptive statistics and bivariate statistical analysis using SAS 9.0 (Cary, NC). RESULTS: There were a total of 1105 immunization eCare plans completed. An increase of 136.6% in vaccines administered occurred after the implementation of the eCare plans. While the number of vaccines administered increased, no significant differences were found in vaccine uptake by gender or age. CONCLUSION: Immunization eCare plans are a useful tool to help pharmacists increase the number of vaccines administered in an independent pharmacy.

Retention of students' knowledge of immunizations following a one-day or a five-week course.

INTRODUCTION: The American Pharmacists Association (APhA) Pharmacy-Based Immunization Delivery Certificate Program is commonly used by schools of pharmacy to train student pharmacists in immunizations. This study compared student pharmacists' knowledge retention of immunization content when the live seminar of the APhA Program was delivered as a one-day co-curricular activity or as a five-week required course. The impact of immunization experience on students' knowledge retention was a secondary objective. METHODS: A 45-question knowledge assessment about immunizations was administered to second and third-year student pharmacists eight months after completing either a five-week course (second-year students) or a one-day seminar (third-year students). Students were also asked about their experience providing patient education, screening, and administering immunizations. RESULTS: Knowledge assessment scores declined by an average of 26.3% from the initial to the eight-month assessment, and declines were similar for second and third-year students. However, students who reported immunizing over 50 patients had significantly higher knowledge retention than those who reported never immunizing. CONCLUSIONS: A live immunization training given over one day or five weeks did not impact the retention of immunization knowledge eight months later. However, students who immunized >50 patients had greater knowledge retention. These findings indicate the importance of including the application of immunization knowledge in pharmacy curricula to enhance long-term knowledge retention.

Evaluation of patient satisfaction and perceptions of a long-acting injectable antipsychotic medication administration service in a community-based pharmacy during the COVID-19 pandemic.

BACKGROUND: The coronavirus disease 2019 (COVID-19) pandemic, restrictions, and social distancing requirements for medical offices reduced scheduling availability and increased virtual televisits by providers. COVID-19 restrictions created a barrier to health care access for patients who are being administered long-acting injectable antipsychotics (LAIs) in an already vulnerable population. OBJECTIVE: To describe an LAI medication administration service at a community-based pharmacy during the COVID-19 pandemic, to evaluate patient satisfaction with the administration of LAIs by a pharmacist service in a community-based pharmacy during the COVID-19 pandemic, and to compare the patient's perceptions of receiving LAIs in a community-based pharmacy with those in another setting previously used for medication administration. PRACTICE DESCRIPTION: Independent full-service community-based pharmacy. PRACTICE INNOVATION: Implementation of an LAI administration service after an increase in provider referrals of patients to the community-based pharmacy during the COVID-19 pandemic. EVALUATION METHODS: A 4-month prospective convenience sample study conducted to evaluate the LAI medication administration service. The survey containing 32 questions was adapted with permission from a previous survey administered in a large grocery store chain to a similar population. Survey results were reported using descriptive statistics. RESULTS: Eleven patients completed the survey. A total of 82% of patients strongly agreed that they felt comfortable with receiving this service at the community-based pharmacy and were satisfied with the privacy during the service. Seventy-one percent of patients who received this service elsewhere strongly agreed the LAI medication administration service was more convenient than a similar service received elsewhere, yet only 18% of patients strongly agreed that the community-based pharmacy was near their work or home. CONCLUSION: A medication administration service for LAIs was developed in a community-based pharmacy, and patients were satisfied with the service. Further research needs to be completed to evaluate health outcomes and financial implications of this service for the patient and health care system.

Perceptions and predictors of intention to receive the COVID-19 vaccine.

BACKGROUND: The control of the Coronavirus Disease 2019 (COVID-19) pandemic may be dependent on widespread receipt of an effective vaccine. It is important to understand patient health-related behaviors and perceptions to guide public health vaccination strategies. OBJECTIVES: To examine perceptions of COVID-19 and vaccination beliefs, and identify predictors of intention to receive the COVID-19 vaccine in the US. METHODS: A cross-sectional, web-based survey guided by the Health Belief Model was conducted using a web-based Qualtrics survey panel of US adults. The main outcome was the intention to receive the COVID-19 vaccine if offered. Additional measures included: demographics, perceptions of COVID-19 severity, risk and susceptibility, views of a potential COVID-19 vaccine, virus and vaccine information sources, vaccine beliefs and behaviors, and seasonal flu vaccine history. RESULTS: A total of 1047 complete responses were included. Females had lower odds of intending to receive the COVID-19 vaccine than males (AOR = 0.54, 95% CI: 0.36-0.80). Those with a two-year degree/some college had lower odds of intending to receive the COVID-19 vaccine compared to those with a high school degree/GED (AOR = 0.59, 95% CI: 0.36-0.97). Respondents who perceived the severity of the virus to be higher, perceived a greater COVID-19 vaccine benefit, and perceived greater general vaccine benefits had higher odds of intending to receive a COVID-19 vaccine (AOR = 1.44, 95% CI: 1.09-1.91; AOR = 2.82, 95% CI: 2.24-3.56; AOR = 1.77, 95% CI 1.41-2.21, respectively). CONCLUSIONS: In this study, intention to receive the COVID-19 vaccine varied across demographics, perceived virus severity, COVID-19 vaccine and general vaccine beliefs. Successful implementation of a COVID-19 immunization strategy by healthcare providers and public health officials will need to incorporate diverse COVID-19 vaccination education strategies tailored to patients' health beliefs.

Community pharmacists in Virginia dispensing naloxone under a standing order: A qualitative study.

BACKGROUND: In 2016, the Virginia Health Commissioner signed a standing order into law allowing licensed pharmacists to dispense opioid receptor antagonists (ORAs) for overdose reversal. OBJECTIVES: Using the theory of planned behavior as an initial guide to study development, the aim of this qualitative study was to explore community pharmacists' attitudes, subjective norm, perceived behavioral control, and behavioral intention toward dispensing ORAs under a standing order in Virginia. METHODS: Semi-structured interviews were conducted with community pharmacists across the Commonwealth between June 2018 and October 2019. Interviews were recorded, transcribed verbatim, and thematically analyzed. RESULTS: Twenty-one community pharmacists were interviewed. Pharmacists were confused about the specifics and the processes involved with dispensing naloxone under the standing order. Furthermore, many recognized the underuse of the standing order. Positive attitudes focused on the life-saving action of ORAs. Negative attitudes included encouraging risky behaviors by patients, negatively affecting the patient-pharmacist relationship, offending or contributing to stigmatizing patrons, and having liability issues to the pharmacy. Subjective norms regarding dispensing of ORAs under the standing order were perceived to be favorable among peer pharmacists and primary care and emergency department physicians but may be seen as profit-seeking by patients. Barriers to service provision included lack of guidance from corporate offices (in chain pharmacies), inadequate training, patient out-of-pocket costs, reimbursement issues, inadequate staffing and time, and stigma. Facilitators comprised the existence of practice site-specific protocols, the REVIVE! training, technician support, increased community awareness, physician collaboration, pharmacist training, and employer guidance. Whereas some pharmacists intended to become more familiarized with the standing order, others did not intend to actively identify patients who were at risk of an opioid overdose. CONCLUSION: Pharmacists expressed mixed behavioral intention toward dispensing ORAs under the standing order. Future research should focus on quantifying the uptake of the standing order at the state level.

Assessment of hemp oil-based cannabidiol use in a community-based pharmacy setting.

BACKGROUND: The Agricultural Improvement Act of 2018 legalized the commercial use of hemp-based products, including cannabidiol (CBD). However, the U.S. Food and Drug Administration (FDA) does not currently regulate the commercial sale of hemp oil-based CBD, and there is no FDA-approved indication for its nonprescription formulations despite the growing demand for, and use of, hemp oil-based CBD. OBJECTIVES: Characterize the use of hemp oil-based CBD, including brands, formulations, and reasons for use, in a community pharmacy setting and identify the perceived barriers related to the use of hemp oil-based CBD. METHODS: A pretested 17-question survey was distributed at the point of care at 2 community pharmacy locations and at hemp oil-based CBD education presentations over a 3-month period. The survey consisted of multiple-choice, open-ended, and select-all-that-apply questions, which were analyzed using univariate and bivariate analyses. RESULTS: A total of 101 participants completed the survey: 38 were CBD-naive, and 63 were CBD-exposed. Most of the participants were women (79%) and Caucasian (81.6%), with an average age of 59 years (SD 17.26). In the CBD-naive group, the most commonly stated barrier to using hemp oil-based CBD was not enough information about the product. Among the participants who had used or were using at least 1 CBD product, the most commonly used dosage form was sublingual, followed by topical: 46 (46/63 [73%]) and 34 (34/63 [54%]) participants, respectively. Thirty-eight participants used hemp oil-based CBD for pain, 24 participants for sleep, and 17 participants for anxiety. Of these, 62% of the participants informed a health care provider that they were using a hemp oil-based CBD product. CONCLUSION: The participants were using different brands and formulations of hemp oil-based CBD for multiple reasons. The greatest barrier to trying CBD was limited education, which may suggest a need for community education about hemp oil-based CBD products.

Development and feasibility of a community pharmacy-driven 24-hour ambulatory blood pressure monitoring service.

BACKGROUND: Although 24-hour ambulatory blood pressure monitoring (ABPM) is recommended by practice guidelines, access to ABPM is poor in the United States. Other countries have increased ABPM access by making it available in community pharmacies. It is not known if a similar approach is feasible in the United States. OBJECTIVE: The objective of this study was to develop and evaluate the feasibility of a community pharmacy-driven ABPM service in the United States. SETTING: Two independent community pharmacies. PRACTICE DESCRIPTION: The ABPM service was developed through a collaboration between an academic partner and the clinical service leads of each pharmacy. Eligible patients were those referred by their provider or self-referred for white coat, masked, or sustained hypertension (HTN), symptoms of hypotension, or requiring confirmation of an initial diagnosis of HTN. The service was appointment-based, and the pharmacist sent the ABPM results and interpretation to the referring provider via facsimile. PRACTICE INNOVATION: This is the first description of a community pharmacy-driven ABPM service in the United States. EVALUATION: Descriptive statistics were used to summarize the data for the baseline demographics, ABPM findings, and a 9-question patient satisfaction survey. RESULTS: A total of 52 patients with a mean (SD) age of 56.6 (16.1) years, 50% women, 75% white, and 71.2% with a prior diagnosis of HTN were enrolled. Forty-six patients (88.5%) had successful ABPM readings with the most common blood pressure phenotypes being nocturnal HTN (91.3%), nondipper (52.1%), sustained HTN (41.3%), normotensive (23.9%), and white coat HTN (19.6%). Overall, 88% of the patients strongly agreed or agreed that they were very satisfied with their experience using the ABPM service. CONCLUSION: A community pharmacy-driven ABPM service is feasible in the United States and may be one approach to improve access to ABPM.

Community-Based Pharmacy Practice Innovation and the Role of the Community-Based Pharmacist Practitioner in the United States.

Community-based pharmacy practice is evolving from a focus on product preparation and dispensing to becoming a health care destination within the four walls of the traditional community-based pharmacy. Furthermore, community-based pharmacy practice is expanding beyond the four walls of the traditional community-based pharmacy to provide care to patients where they need it. Pharmacists involved in this transition are community-based pharmacist practitioners who are primarily involved in leading and advancing team-based patient care services in communities to improve the patient health. This paper will review community-based pharmacy practice innovations and the role of the community-based pharmacist practitioner in the United States.

Decision-maker and staff perceptions of the pharmacist's role in transitions of care programs.

OBJECTIVES: To identify perceptions of decision-makers and staff at a local hospital about the pharmacist's role in transitions of care (TOC) programs. SETTING: Independent community pharmacy located inside a local community hospital. PRACTICE DESCRIPTION: Pharmacy personnel offer a bedside delivery service to hospital patients and have professional relationships with administration. PRACTICE INNOVATION: Pharmacy personnel intend to expand the bedside delivery service to a comprehensive TOC program. Researchers believed it would be important to gather the perceptions of pharmacist's role in TOC programs from nonpharmacist clinicians and administration to successfully develop the program. EVALUATION: This project would identify perceptions to help develop a TOC program. METHODS: A 22-question survey was developed after consulting with key staff and informed by literature regarding TOC and pharmacists' roles in patient care services. Collected demographic information included primary department, number of years worked at the institution, and involvement in TOC. After an 8-week survey distribution period, descriptive statistics were performed on the data collected. RESULTS: A total of 13 decision-makers and staff responded to the survey with a response rate of 87%. Eleven of 12 respondents (92%) thought that pharmacists should be involved in TOC and can be the communication link between patients and other health care providers to ensure continuity of care. All of the participants thought that pharmacists should provide medication reconciliation and patient and caregiver education through TOC services. The participants were less likely to think that pharmacists should offer follow-up care after discharge. CONCLUSION: Participants agreed that pharmacists should be involved in TOC services but had varied perceptions on the pharmacist's specific role. Decision-maker and staff perceptions identified in this study will be used to develop the pharmacist's role in a TOC program at the institution.

Public attitudes and beliefs about Virginia community pharmacists dispensing and administering naloxone.

OBJECTIVES: To determine awareness concerning naloxone and perceived severity of opioid overdose, to identify attitudes and beliefs concerning naloxone, and to assess perceived benefits and barriers related to naloxone dispensed and administered by community pharmacists. METHODS: The project was conducted in 3 phases. Phase 1 consisted of survey development and pretesting to identify unclear questions. The survey used principles of the health belief model, focusing on perceived severity of opioid overdose, perceived barriers and benefits to community pharmacists dispensing and administering naloxone, naloxone awareness, sources of health information, and attitudes and beliefs about naloxone. Question types were 5-point Likert response scale with several multiple choice and dichotomous questions. In phase 2, the paper-based survey was distributed to adults in the Richmond area from December 2016 to June 2017. Phase 3 consisted of data analysis using descriptive statistics. RESULTS: One hundred twenty-nine individuals with a mean age of 35.4 years (56.7% male and 44.4% white) completed the survey. Opioid overdose was identified as a serious problem in the Richmond area and the United States by 71.9% and 81.3% of respondents, respectively. Among respondents, 39.5% had heard of naloxone before the survey. Most respondents were comfortable with a community pharmacist dispensing and administering naloxone (66.4% and 64.0%, respectively). Of the 31 respondents who were not comfortable with pharmacists dispensing or administering naloxone, 18 respondents identified promoting drug abuse and misuse and 12 respondents identified promoting reckless behavior as a perceived barrier. CONCLUSIONS: While most survey respondents were not aware of naloxone before completing the survey, the majority were in favor of community pharmacists in Virginia dispensing and administering naloxone. The most commonly identified concern is that pharmacists dispensing naloxone would promote drug abuse and misuse, which should be addressed with patient education.

Antidepressant Use and Incident Urinary Incontinence: A Literature Review.

OBJECTIVE: To review available data examining antidepressant use and incident urinary incontinence (UI). DATA SOURCES: PubMed was used to conduct the literature search for this review. In the primary search, the term "antidepressive agents" was searched as a medical subject heading, a pharmacological action, and a keyword phrase. This choice was made so that any relevant articles would include complete results for antidepressive agents. "Antidepressive agents" was combined with the key phrase "drug-induced urinary incontinence" to complete this primary search. STUDY SELECTION: Relevant articles published in English and examining human subjects were included. DATA EXTRACTION: The study authors determined appropriateness of articles for inclusion, focusing on those examining antidepressant-associated UI. DATA SYNTHESIS: This literature review identified three cohort studies and 11 case reports examining various associations between antidepressant use and incident UI. CONCLUSION: All 11 case reports and 1 cohort study reviewed suggest an association between antidepressant use and incident UI. It remains unclear which drugs are most problematic and which patients are at greatest risk, and more data are needed to confirm an association, especially in older adults. Comprehensive medication reviews should be employed by pharmacists to identify potential medication-related causes of UI.

Concordance of Pharmacist Assessment of Medication Nonadherence With a Self-Report Medication Adherence Scale.

OBJECTIVE: To evaluate the concordance of the Modified Morisky Scale (MMS) with a pharmacist assessment of medication adherence during a medication review. METHODS: This retrospective study examined the electronic medical records (EMRs) of patients ≥18 years who received a medication review by a pharmacist from October 2008 to September 2009 at a homeless behavioral health clinic. In addition to the 6-item MMS, adherence was assessed using the first 4 items of the MMS, which comprise the original Morisky Scale. A final pharmacist assessment of adherence based upon the medication review was documented in the EMR. The McNemar test was used to assess the agreement between the MMS (6 and 4 items) and the pharmacist assessment of medication adherence. RESULTS: A total of 288 patients were eligible for the study, which included 449 medication reviews. Nonadherence was identified in 61.7% and 49.7% of medication reviews using the 6 and 4 items of the MMS. The pharmacist assessment determined nonadherence in 23.8% of medication reviews. There were significant differences between the pharmacist adherence assessment and the 6 (P < .0001) and 4 (P < .0001) items of the MMS. CONCLUSION: A combination of methods including self-report and pharmacist assessment may provide the greatest insight into adherence.

Evaluating health outcomes following a pharmacist-provided comprehensive pretravel health clinic in a supermarket pharmacy.

OBJECTIVES: To evaluate health outcomes and acceptance of pharmacists' recommendations of travel health including prevalance of immunizations, sunburn, insect-borne diseases, traveler's diarrhea, and altitude sickness, and assess patient satisfaction with the pretravel health clinic. DESIGN: Retrospective cross-sectional study design. SETTING: Central Virginia, July 2011 to June 2012. PARTICIPANTS: Patients 18 years and older who had an appointment with the pharmacist for pretravel health. INTERVENTION: Interview/survey administered to patients by telephone. MAIN OUTCOME MEASURES: Health outcomes, acceptance rates of pharmacist's travel health recommendations, and patient satisfaction. RESULTS: Of 356 patients eligible to participate in the study, 103 patients participated, 30 patients declined, and 223 patients could not be reached by telephone (29% response rate). Pharmacists' recommendations for travel immunizations (100% acceptance rate for yellow fever and 82% for Typhoid) and nonpharmacologic preventive measures (prevention of sunburn, traveler's diarrhea, insect bites, and altitude sickness) were well accepted by respondents, and occurrence of these adverse events was low. Patients were satisfied overall with the education and services that the pharmacist delivered in the pretravel health clinic. CONCLUSION: Pharmacists providing services in pretravel health clinics can have substantial impact on the health of patients traveling internationally.

Homeless patients' use of urban emergency departments in the United States.

Data from the 2009-2010 National Hospital Ambulatory Care Survey-Emergency Department were used to compare homeless patients' utilization of the urban emergency department (ED) in the United States with nonhomeless patients and to examine the relationship between homelessness and demographics and ED utilization measures. The weighted sample size was 200 645 347. A total of 1 302 256 patients (0.65%) were homeless. Homeless patients were significantly more likely to be older, male, have self-pay, have no charge/charity or other as payment type, arrive via ambulance, have a longer ED visit, and a past visit to the same ED in the last year.

Medication adherence challenges among patients experiencing homelessness in a behavioral health clinic.

BACKGROUND: Behavioral health medication nonadherence is associated with poor health outcomes and increased healthcare costs. Little is known about reasons for nonadherence with behavioral health medications among homeless people. OBJECTIVES: To identify reasons for medication nonadherence including the sociodemographic, health-related factors, and behavioral health conditions associated with medication nonadherence among behavioral health patients served by a Health Care for the Homeless center (HCH) in Virginia. METHODS: The study sample was selected from an existing database that included sociodemographic, health-related information, and medication-related problems identified during a pharmacist-provided medication review conducted during October 2008-September 2009. Patients experiencing or at risk of homelessness who were ≥18 years old with at least one behavioral health condition who had a medication review were eligible for the study. A qualitative content analysis of the pharmacist documentation describing the patient's reason(s) for medication nonadherence was conducted. The Behavioral Model for Vulnerable Populations was the theoretical framework. The outcome variable was self-reported medication nonadherence. Descriptive and multivariate (logistic regression) statistics were used. RESULTS: A total of 426 individuals met study criteria. The mean age was 44.7 ± 10.2 years. Most patients were African-American (60.5%) and female (51.6%). The content analysis identified patient-related factors (74.8%), therapy-related factors (11.8%), and social or economic factors (8.8%) as the most common reasons for patients' medication nonadherence. Patients with post-traumatic stress disorder (PTSD) (adjusted odds ratio: 0.4; 95% CI: 0.19-0.87) were less likely to have a medication adherence problem identified during the medication review. CONCLUSIONS: The content analysis identified patient-related factors as the most common reason for nonadherence with behavioral health medications. In the quantitative analysis, patients with a PTSD diagnosis were less likely to have nonadherence identified which may be related to their reluctance to self-report nonadherence and their diagnosis, which warrants further study.

Student pharmacists' perceptions and awareness of community pharmacy practice residency programs.

OBJECTIVES: To assess student exposure to types of pharmacy practice, evaluate awareness and perceptions of community pharmacy residencies, and identify areas of postgraduate training of interest to student pharmacists. DESIGN: Cross-sectional, descriptive, online survey study. SETTING: United States, January to April 2008. PARTICIPANTS: Student pharmacists in the final 2 years of the doctor of pharmacy (PharmD) program. INTERVENTION: An online survey was administered to students in the final 2 years of the PharmD program at randomly selected schools of pharmacy by region throughout the United States. MAIN OUTCOME MEASURES: Awareness of student pharmacists regarding community pharmacy residencies and interest in postgraduate training. RESULTS: 254 surveys were completed during the study period. Of the respondents, 95% had previous experience working in a community pharmacy setting. Nearly 90% were aware of community pharmacy residencies. Students who indicated opportunities to publish (odds ratio 2.4 [95% CI 1.34-4.1]), teaching students (2.1 [1.36-3.14]), enjoying the job atmosphere (4.9 [1.54-15.60]), and clinically challenging (4.3 [2.15-8.67]) as desirable career attributes were more likely to be interested in postgraduate training. No significant differences existed in the information sources sought by students interested in community pharmacy residency programs (CPRPs) compared with those interested in other types of postgraduate training. CONCLUSION: The significant predicators of student pharmacists interested in pursuing postgraduate training are in alignment with CPRP training. Further research is needed to market the value of CPRPs through the identified information sources.

The use of the health belief model to assess predictors of intent to receive the novel (2009) H1N1 influenza vaccine.

OBJECTIVES: 1) Assess participants' perceptions of severity, risk, and susceptibility to the novel H1N1 influenza virus and/or vaccine, vaccine benefits and barriers, and cues to action and 2) Identify predictors of participants' intention to receive the novel H1N1 vaccine. DESIGN: Cross-sectional, descriptive study SETTING: Local grocery store chain and university in the central Virginia area PARTICIPANTS: Convenience sample of adult college students and grocery store patrons INTERVENTION: Participants filled out an anonymous, self-administered questionnaire based upon the Health Belief Model. MAIN OUTCOME MEASURES: Participants' predictors of intention to receive the novel H1N1 vaccine RESULTS: A total of 664 participants completed a questionnaire. The majority of participants were aged 25-64 years old (66.9%). The majority were female (69.1%), Caucasian (73.7%), and felt at risk for getting sick from the virus (70.3%). Most disagreed that they would die from the virus (68.0%). Participants received novel H1N1 vaccine recommendations from their physicians (28.2%), pharmacists (20.7%), and nurses (16.1%). The majority intended to receive the H1N1 vaccine (58.1%). Participants were significantly more likely to intend to receive the H1N1 vaccine if they had lower scores on the perceived vaccine barriers domain (OR= 0.57, CI: 0.35-0.93). Physicians' recommendations (OR=0.26, CI: 0.11-0.62) and 2008 seasonal flu vaccination (OR=0.45, CI: 0.24-0.83) were significant predictors of intention to receive the H1N1 vaccine. CONCLUSIONS: Most participants felt at risk for getting the novel H1N1 virus and intended to receive the novel H1N1 vaccine. Educating patients about vaccine benefits and increasing healthcare professionals' vaccine recommendations may increase vaccination rates in future pandemics.

Implementation of a personal medication record program in an independent living facility.

OBJECTIVE: To describe the process of implementing a "Vial of Life" [Lifesaving Information for Emergencies] program in an independent living facility. SETTING: An independent living facility in the Richmond, Virginia, area. PRACTICE DESCRIPTION: The average age of the residents is 79.75 years, with 75% of the population being female. The facility offers social, cultural, and recreational activities, health and wellness programs, a salon, and outdoor activities. PRACTICE INNOVATION: Implementing the Vial of Life Project into an independent living facility. MAIN OUTCOME MEASUREMENTS: The number of patients who have participated in the Vial of Life Project; the implementation experience and student exposure to the implementation process. RESULTS: There were 12 residents out of 83 total who elected to receive the service from a pharmacist. This resulted in a 14.45% participation rate. In addition, the faculty and students were exposed to the program and its implementation in an independent living facility. CONCLUSION: The Vial of Life Project has allowed for increase in access to the pharmacist for education and medication reviews.