Establishment and evaluation of scalable COVID-19 vaccine clinics at a large university.

BACKGROUND: Previous large-scale vaccination clinics have been successful before the coronavirus disease 2019 (COVID-19) pandemic; however, owing to the strict storage requirements and pharmaceutical preparation needed for the COVID-19 vaccines, careful thought and planning were necessary to successfully deploy these clinics immediately after vaccine availability. The focus of this manuscript is to describe the development and implementation of COVID-19 vaccination clinics in a large public university, using professionals from within and outside of its health sciences schools. OBJECTIVES: The primary objective of this project was to (1) implement COVID-19 vaccination clinics for university faculty, staff, students, and community members. Additional objectives of the clinics were to (2) actively incorporate pharmacy, nursing, and medical students into the clinic workflow; (3) promote interprofessional collaboration among faculty and students; and (4) assess patient satisfaction. PRACTICE DESCRIPTION: The School of Pharmacy faculty, in conjunction with the Office of Strategic Initiatives, planned and coordinated COVID-19 vaccination clinics from December 2020 to July 2021. Students and faculty from schools of pharmacy, nursing, and medicine were used. COVID-19 vaccinations were offered to university faculty, staff, and students and community members based on the Centers for Disease Control and Prevention priority groups. The clinic processes were designed such that they could be scaled from 100 to 2,000 participants per day. PRACTICE INNOVATION: The School of Pharmacy led approach was adjustable depending on the number of patients, continuously monitored and adaptable. The importance of pharmacists as part of the interprofessional health care team was exemplified by faculty and students involved. EVALUATION METHODS: All patients receiving COVID-19 vaccinations at the clinics were e-mailed anonymous surveys for assessment of the quality of the vaccination encounter after completion of their primary vaccine series. RESULTS: More than 15,000 COVID-19 vaccinations were provided through the clinics from December 2020 to July 2021. Professional staffing totaled 3352 hours for the 48 clinics. Thirty-eight percent of the vaccinated patients responded to the clinic satisfaction survey with predominately excellent ratings. CONCLUSION: COVID-19 vaccination clinics can be successfully planned and implemented in a scalable fashion in a large university setting using an interprofessional team approach.

Impact of naloxone education for patients receiving buprenorphine-containing prescriptions indicated for opioid use disorder at an independent community pharmacy.

OBJECTIVES: A pilot study was conducted to identify whether an opioid education and naloxone distribution (OEND) service affected (1) willingness to accept naloxone; (2) naloxone dispensation; and (3) patient knowledge about opioids, overdose symptoms, and naloxone in patients receiving buprenorphine prescriptions for opioid use disorder (OUD). METHODS: Participants were enrolled from January 2, 2019, to February 15, 2019, in this prospective noncontrolled study when receiving a buprenorphine prescription at the study site. The exclusion criteria included prescriptions being picked up by someone other than the patient and those who were below 18 years of age. The participants completed a written pre- and postsurvey containing "Yes" or "No," "Select all that apply," and open-ended questions assessing (1) willingness to accept naloxone and (2) change in opioid and naloxone knowledge. RESULTS: Fifty-two participants were enrolled, and all completed the pre- and postsurveys. After the education, there was a not statistically significant change in the proportion of participants willing to accept naloxone from the pharmacy (28.8% vs. 36.5%; P = 0.31). In addition, there was an improvement in the proportion of participants believing that they need to carry naloxone with them (15.4% vs. 40.4%; P < 0.001). Naloxone dispensing increased 400% after the intervention implementation. Improvements in opioid knowledge also occurred. More participants correctly identified buprenorphine as an opioid (48.1% vs. 86.5%; P < 0.001), and correctly identified that methamphetamine (19.2% vs. 3.8%; P = 0.02) and cocaine (17.3% vs. 3.8%; P = 0.03) are not opioids. Of the 52 participants enrolled, 11.5% correctly identified all opioids on the presurvey, whereas 50% correctly identified all opioids on the postsurvey. CONCLUSION: Patients diagnosed with OUD who are prescribed buprenorphine may be at high risk of an overdose if they return to use; yet, few OEND programs specifically target this population. This study suggests that OEND based in community pharmacies may be a strategy to increase naloxone access among these patients.

Impact of Pharmacist Delivered Education on Early Parent Awareness and Perceptions Regarding Human Papillomavirus (HPV) Vaccination in the Community Pharmacy Setting in West Virginia.

OBJECTIVES: (1) Define parental perceptions of the Human Papillomavirus Vaccine and awareness of vaccine administration at community pharmacies (2) Describe parental intentions to have children vaccinated against HPV (3) Describe reasoning process behind parental vaccination intentions (4) Assess impact of pharmacist-led education on these perceptions and intentions. METHODS: This was a prospective pretest, posttest study with a convenience sample conducted at parenting groups throughout northern West Virginia in 2018. Participants, a total of 34 parents/guardians, attended an educational session regarding Human Papillomavirus (HPV) vaccination with immediate pre/post survey. The survey asked participants about their HPV vaccination history, personal perceptions regarding the HPV vaccine, age and gender of their children, overall immunization status of the child, current intent regarding the HPV vaccine, parents' preferred resources for vaccine information, awareness of HPV vaccine availability in community pharmacies, as well as parent developed environment (rural, suburban, urban, etc.), race, age, marital status, education, and income level. RESULTS: Following intervention, intention to vaccinate according to the Advisory Committee on Immunization Practices (ACIP) recommendations increased from 35% (n=12) to 44% (n=15). The percentage of participants against vaccinating decreased from 23% (n=8) to 12% (n=4). Participants demonstrated increased awareness of HPV vaccine availability at community pharmacies, with awareness increasing from 32% (n=11) to 100% (n=34). CONCLUSIONS: Pharmacist delivered education may be useful in increasing parent/legal guardian awareness of immunization services as well as intention to vaccinate their child.

Assessment of targeted automated messages on herpes zoster immunization numbers in an independent community pharmacy.

OBJECTIVES: To evaluate the impact of an automated phone call by a pharmacy owner on the number of herpes zoster vaccinations given in the independent community pharmacy setting, compare herpes zoster immunization numbers in the 3 months during the previous year to the 3 months during the intervention, and assess patient satisfaction with the automated phone call service. METHODS: This prospective study took place in an independent community pharmacy. A message was recorded by the pharmacy owner using a telephone-message program that notified patients aged 60 and older that the herpes zoster vaccine is recommended for them. This message was sent out monthly for a total of 3 months. Patients who received this vaccine in the 3 months following the initial phone call were surveyed to determine their reason for receiving the vaccine, and to assess satisfaction with the phone call. The total number of herpes zoster immunizations given at the pharmacy during the study period was compared to the total given at the pharmacy during the same period of the previous year. RESULTS: A total of 25 participants received the herpes zoster vaccine at the pharmacy during the study period, compared to 16 during the control period. Receiving the phone call was the most commonly cited reason for receiving the vaccine, followed by doctor recommendation. Of the 18 participants who received the call, 12 stated that they would be very likely to respond to similar phone calls in the future. CONCLUSION: These results demonstrate that using a targeted, automated phone call directed at eligible patients appears to have a positive effect on their willingness to receive the herpes zoster vaccine and may lead to an increase in vaccination numbers among eligible patients. Various factors must be considered before implementation of this service, including cost and added call volume.

The impact of medication synchronization on quality care criteria in an independent community pharmacy.

OBJECTIVES: To determine the impact of a comprehensive medication synchronization program in an independent community pharmacy by (1) evaluating changes in Electronic Quality Improvement Platform for Plans and Pharmacies (EQuIPP) scores and (2) examining the change in monthly prescription volume. SETTING: Independent community pharmacy in Morgantown, WV. PRACTICE DESCRIPTION: Waterfront Family Pharmacy is a single-location independent community pharmacy located in Morgantown, WV. The pharmacy consists of four full-time pharmacists and is the primary practice site for one community pharmacy PGY-1 resident. The pharmacy provides a variety of clinical services, including vaccine administration, medication therapy management, and diabetes education services. PRACTICE INNOVATION: In September 2014, Waterfront Family Pharmacy started a comprehensive medication synchronization program. EVALUATION: Change in Electronic Quality Improvement Platform for Plans and Pharmacies (EQuIPP) scores and change in monthly prescription volume. RESULTS: At the end of 6 months there was improvement in all targeted EQuIPP scores. There was a 7% improvement in proportion of days covered (PDC) for cholesterol-reducing agents, a 9.5% improvement in PDC for oral glycemic agents, a 1.2% improvement in PDC for renin-angiotensin system antagonists, and a 1.8% reduction in the use of high-risk medications in the elderly. There was also an average increase in monthly prescription volume of 4.8% over the first 6 months after the implementation of the comprehensive medication synchronization program. CONCLUSION: The implementation of a comprehensive medication synchronization program in an independent community pharmacy may result in benefits including improved EQuIPP scores and increased prescription volume.

Students as catalysts to increase community pharmacy-led direct patient care services.

OBJECTIVE: To describe the impact on community pharmacy service development of a faculty-student-pharmacist collaborative program offered by five U.S. colleges. SETTING: Colleges of pharmacy and community pharmacies in Arizona, Illinois, Ohio, Utah, and West Virginia. PRACTICE DESCRIPTION: Partner for Promotion (PFP) is an elective, longitudinal advanced pharmacy practice experience (APPE) focused on enhancement of community pharmacy management skills, specifically the development and implementation of direct patient care services. This faculty-student-pharmacist collaborative model has been implemented in five U.S. colleges of pharmacy beyond the originating institution. EVALUATION: Data on pharmacy demographics and the impact of PFP on service creation and longevity at these partnering schools were reported via annual online surveys completed by faculty directors at each partnering college of pharmacy. RESULTS: Over a 3-year period, 19 pharmacy teams across five states worked to create a total of 15 direct patient care services, 12 of which were still being offered to patients at the time of data collection (80% longevity). The PFP program guided 38 students through the process of developing and implementing a sustainable service at a community pharmacy. All participating faculty from partnering colleges of pharmacy (100%) indicated that PFP model materials were "very useful" (4-point Likert scale; 1, not useful, to 4, very useful), and all five colleges plan to continue offering the program moving forward. CONCLUSION: The PFP model of training and service development can have a positive impact on the pharmacy profession, serve as an avenue for training students in the development of clinical services, and be a catalyst for establishing the growth of community pharmacy as a patient-centered, service-oriented partner in the health care system.

Interventions for being active among individuals with diabetes: a systematic review of the literature.

PURPOSE: The purpose of this systematic review is to assess and summarize evidence and gaps in the literature regarding the intervention for being active (exercise) among individuals with diabetes. METHODS: Twelve electronic databases were searched. Publications eligible for inclusion specifically studied learning, behavioral, clinical, and humanistic outcomes for exercise interventions in adult patients with type 1 and type 2 diabetes. RESULTS: Seven reviews (2 systematic reviews, 3 meta-analyses, 2 technical reviews) and 34 individual, nonreview studies (18 randomized controlled trials, 16 nonrandomized trials) met inclusion criteria. For type 2 diabetes, findings suggested that exercise had a positive effect on glycemic control and decreased cardiovascular risk, but the impact of exercise on behavioral and humanistic outcomes was unclear; long-term outcomes and adherence to exercise interventions is unknown because most studies were of short duration. The overall impact of varied types of exercise in type 1 diabetes was unclear, especially regarding glycemic control. Potential benefits of exercise in type 1 may include improved cardiovascular health. CONCLUSION: The review did not identify specific successful intervention details because of the heterogeneity of studies, subjects, and research gaps. General findings suggest that physical activity is better than no exercise at all; intensive regimens, if tolerated by patients, achieved better clinical outcomes than less intensive regimens. Reviewed studies using structured exercise regimens exhibited a more significant impact on outcomes. Substantial gaps in the literature include studies measuring direct effects of exercise in the US minority populations most affected by type 2 diabetes and economic evaluations of exercise interventions. Interventions must be tailored to individual patient needs to succeed.