Centre for Applied Health Economics, 1.11 N78, 170 Kessels Road, Griffith University, Nathan, Qld 4111, Australia. Email:
Australian Government, Department of Health, Level 15, 160 Ann Street, Brisbane, Qld 4000, Australia. Email:
Aust Health Rev. 2020 Aug;44(4):582-589. doi: 10.1071/AH19196.
Objective The aims of this study were to estimate the effect of pharmacists' vaccinating for influenza on overall vaccination rates and to assess whether any effect differs for at-risk subgroups compared with the general population. Methods A systematic review was undertaken, adhering to the Preferred Reporting Items for Systematic reviews and Meta-Analyses (PRISMA) guidelines. Databases were searched during July 2019 and included Medline (Ovid), Cumulative Index to Nursing and Allied Health Literature (CINAHL), Scopus and the Cochrane Library. Results The largest difference reported in overall population vaccination rates associated with pharmacists undertaking influenza vaccinations was an increase of 10%; the smallest showed no discernible effect. The effect was graduated: pharmacists with the most autonomy demonstrated the largest rate increases. There was evidence of substitution by pharmacists, but the effect size was small. Conclusions The effect of allowing pharmacists to administer influenza vaccinations appears positive, but small. Given that pharmacists are likely to provide vaccinations at a lower cost than doctors, there may be cost-savings to the health system and consumers. Future research may include evaluating pharmacist-provided vaccinations compared with (or in combination with) other strategies, such as advertising, to increase access and uptake across the range of providers, as well as ongoing research to address vaccine hesitancy. What is known about the topic? In Australia, and many other countries, community pharmacies provide an alternative and accessible option for influenza vaccination; however the effect on overall vaccination rates remains unclear. What does this paper add? This systematic review of the international literature suggests that pharmacist-provided vaccinations increase uptake; substitution of doctors by pharmacists may result in cost savings. What are the implications for practitioners? The findings of this study are important for health policy makers and health workforce researchers aiming to maximise population vaccination rates and workforce efficiency. In the absence of available Australian data, data from the international experience of legislating pharmacists to vaccinate against influenza are summarised and critiqued. Results can be used when determining the best health workforce and policy mix with regard to the vaccination workforce.
目的 本研究旨在评估药剂师接种流感疫苗对总体疫苗接种率的影响，并评估与一般人群相比，这种影响是否在高危亚组中有所不同。
方法 本系统评价遵循系统评价和荟萃分析的首选报告项目（PRISMA）指南进行。数据库于 2019 年 7 月进行搜索，包括 Medline（Ovid）、护理和联合健康文献累积索引（CINAHL）、Scopus 和 Cochrane 图书馆。
结果 与药剂师接种流感疫苗相关的总体人群疫苗接种率报告的最大差异增加了 10%；最小的则没有明显效果。效果是渐进的：自主权最大的药剂师显示出最大的增长率。有证据表明药剂师有替代作用，但效果较小。
结论 允许药剂师接种流感疫苗的效果似乎是积极的，但很小。鉴于药剂师提供疫苗的成本可能低于医生，因此可能会为卫生系统和消费者节省成本。未来的研究可能包括评估药剂师提供的疫苗接种与（或与）其他策略（如广告）的比较，以提高所有提供者的可及性和接种率，以及持续研究以解决疫苗犹豫问题。
关于这个话题，人们已经了解到什么？在澳大利亚和许多其他国家，社区药房提供了一种替代和方便的流感疫苗接种选择；然而，其对总体疫苗接种率的影响仍不清楚。
这篇论文增加了什么？这项对国际文献的系统综述表明，药剂师提供的疫苗接种增加了接种率；药剂师替代医生可能会带来成本节约。
对从业者有什么影响？本研究结果对旨在最大限度提高人群疫苗接种率和劳动力效率的卫生政策制定者和卫生劳动力研究人员具有重要意义。由于缺乏可用的澳大利亚数据，本文总结和批判了国际立法授权药剂师接种流感疫苗的经验数据。在确定最佳疫苗接种劳动力和政策组合方面，可以利用这些结果。
