The Cecil G. Sheps Center for Health Services Research, University of North Carolina, Chapel Hill, North Carolina.
Department of Health Behavior, Gillings School of Global Public Health, University of North Carolina, Chapel Hill, North Carolina.
Cancer Epidemiol Biomarkers Prev. 2018 Aug;27(8):970-978. doi: 10.1158/1055-9965.EPI-18-0380. Epub 2018 Jun 5.
State laws about pharmacists providing human papillomavirus (HPV) vaccines vary considerably, limiting many pharmacists' ability to provide this important cancer prevention service. We characterized physician and parent support for pharmacist-provided HPV vaccination for adolescents who are past due for vaccination. In 2014 to 2015, we conducted two national U.S. surveys of 776 primary care physicians (PCPs) and 1,504 parents of adolescents. Respondents indicated the extent to which they supported pharmacist-provided HPV vaccination for 13- to 17-year-olds who are past due. Respondents could endorse the provision unconditionally, or only if certain conditions were met, such as pharmacists receiving proper vaccination training. We used multivariable logistic regression to assess correlates of support. Most physicians (79%) and parents (81%) endorsed pharmacist-provided HPV vaccination if pharmacists had received proper vaccination training, reported vaccine doses to adolescents' PCP, and referred adolescents to PCPs for other health services. Family medicine physicians were more likely than pediatricians to support trained pharmacists providing HPV vaccination [OR = 1.62; 95% confidence interval (CI) 1.17-2.22]. Support was also higher among physicians who practiced in Western states (OR = 2.11; 95% CI, 1.30-3.40). Parents' odds of endorsing trained pharmacists provision of HPV vaccine increased with higher overall satisfaction with their pharmacy's services (OR = 1.10; 95% CI, 1.02-1.19), belief in pharmacists' competence in vaccination practices (OR = 1.42; 95% CI, 1.18-1.70), and overall vaccine confidence (OR = 1.30; 95% CI, 1.15-1.48). To increase support for HPV vaccination services, pharmacists should raise awareness about their immunization training and standardize vaccination protocols that ensure coordination with primary care. Stakeholders' feedback and buy-in is important to help guide expansion of HPV vaccination in pharmacies. .
州法律关于药剂师提供人类乳头瘤病毒（HPV）疫苗的规定差异很大，限制了许多药剂师提供这种重要癌症预防服务的能力。我们描述了医生和家长对药剂师为错过接种疫苗的青少年提供 HPV 疫苗接种的支持程度。在 2014 年至 2015 年期间，我们对 776 名初级保健医生（PCP）和 1504 名青少年家长进行了两项美国全国性调查。受访者表示他们在多大程度上支持药剂师为错过接种疫苗的 13 至 17 岁青少年提供 HPV 疫苗接种。受访者可以无条件地支持，也可以仅在满足某些条件的情况下支持，例如药剂师接受适当的疫苗接种培训。我们使用多变量逻辑回归来评估支持的相关性。大多数医生（79%）和家长（81%）支持接受过适当疫苗接种培训的药剂师提供 HPV 疫苗接种，如果药剂师向青少年的 PCP 报告疫苗剂量并将青少年转介给 PCP 进行其他健康服务。家庭医学医生比儿科医生更有可能支持接受过培训的药剂师提供 HPV 疫苗接种[比值比（OR）=1.62；95%置信区间（CI）1.17-2.22]。在西部各州执业的医生中，支持率也更高（OR=2.11；95%CI，1.30-3.40）。家长对接受过培训的药剂师提供 HPV 疫苗的可能性随着对其药房服务总体满意度的提高而增加（OR=1.10；95%CI，1.02-1.19），对药剂师在疫苗接种实践方面能力的信任（OR=1.42；95%CI，1.18-1.70）和总体疫苗信心（OR=1.30；95%CI，1.15-1.48）。为了增加对 HPV 疫苗接种服务的支持，药剂师应提高对其免疫接种培训的认识，并使疫苗接种方案标准化，以确保与初级保健的协调。利益相关者的反馈和认可对于帮助指导在药房扩大 HPV 疫苗接种非常重要。
