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利用算法评估在由药学学生主导的全州免费健康筛查中就诊的患者的疫苗接种情况。

Using an Algorithm to Assess Vaccination Among Patients Who Attended a Pharmacy Student-Driven Statewide Free Health Screening.

机构信息

Division of Pharmacy Practice and Administration, University of Missouri-Kansas City School of Pharmacy, Kansas, MO, USA.

Department of Pharmacy Practice, University of Missouri-Kansas City School of Pharmacy, Kansas, MO, USA.

出版信息

J Pharm Pract. 2020 Aug;33(4):425-432. doi: 10.1177/0897190018815367. Epub 2018 Dec 13.

Abstract

BACKGROUND

National vaccination rates remain below goals. Given the geographic availability of community pharmacies, pharmacists are uniquely positioned to provide immunizations. However, many pharmacists may not be proactively recommending vaccinations to patients.

OBJECTIVE

The objective of this project was to assess recommendation acceptance rates among patients who attended a pharmacy student-driven statewide free health screening.

METHODS

A brief algorithm addressing 4 routine adult vaccinations was created for use by student pharmacists to initiate conversations regarding potentially indicated vaccines with patients. This algorithm was employed at statewide screenings in 2014 and 2015 with expert users available for further discussion. Follow-up to determine recommendation acceptance and identify barriers to immunization occurred 3 to 12 months after screening. The primary end point of change in immunization recommendation acceptance rates between 2014 and 2015 was analyzed using a chi-square test; secondary objectives included changes in consent rates and thematic analysis of reported barriers.

RESULTS

A total of 1016 patients were screened. Of these, 403 (39.7%) patients gave consent for student pharmacists to follow-up on vaccine recommendations. The overall recommendation acceptance rate was 27%, with approximately 46% of patients accepting at least 1 recommendation. Acceptance rates significantly decreased in the second year (36.5% vs 23.5%, < .001), while consent for follow-up significantly increased (20% vs 64%, < .001). Commonly reported barriers to immunization included resistance to vaccines, forgetfulness, and cost.

CONCLUSION

This algorithm provided a method for novice users to initiate conversations with patients about immunizations and may allow novices to act as pharmacist extenders to improve immunization rates.

摘要

背景

全国疫苗接种率仍低于目标。鉴于社区药房的地理位置,药剂师具有独特的优势,可以提供免疫接种服务。然而,许多药剂师可能没有主动向患者推荐疫苗。

目的

本项目旨在评估在参加由药学学生主导的全州免费健康筛查的患者中,建议接受率。

方法

为学生药剂师创建了一个针对 4 种常规成人疫苗的简短算法,用于与患者就潜在推荐疫苗进行对话。该算法于 2014 年和 2015 年在全州范围内的筛查中使用,并有专家用户可进行进一步讨论。在筛查后 3 至 12 个月进行后续行动,以确定建议的接受情况并确定免疫接种的障碍。使用卡方检验分析 2014 年至 2015 年之间免疫接种建议接受率变化的主要终点;次要目标包括同意率的变化和报告障碍的主题分析。

结果

共有 1016 名患者接受了筛查。其中,403 名(39.7%)患者同意学生药剂师跟进疫苗建议。总体建议接受率为 27%,约有 46%的患者接受至少 1 项建议。第二年的接受率显著下降(36.5%比 23.5%,<.001),而同意跟进的比例显著增加(20%比 64%,<.001)。常见的免疫障碍包括对疫苗的抵制、健忘和费用。

结论

该算法为新手用户提供了一种与患者就疫苗接种进行对话的方法,并且可能允许新手充当药剂师的延伸,以提高免疫接种率。

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