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提供免疫服务的挑战与机遇:对发展中国家药剂师样本的横断面研究数据分析

Challenges and opportunities to provide immunization services: Analysis of data from a cross-sectional study on a sample of pharmacists in a developing country.

作者信息

Sakr Fouad, Dabbous Mariam, Rahal Mohamad, Salameh Pascale, Akel Marwan

机构信息

School of Pharmacy, Lebanese International University Beirut Lebanon.

École Doctorale Sciences de la Vie et de la Santé, Université Paris-Est Créteil Créteil France.

出版信息

Health Sci Rep. 2023 Apr 13;6(4):e1206. doi: 10.1002/hsr2.1206. eCollection 2023 Apr.

Abstract

BACKGROUND AND AIMS

Vaccine-preventable illnesses continue to be a global health concern as immunization coverage remains below its targets. National plans emphasize on the essential role of multidisciplinary efforts and approaches to vaccination programs. Pharmacists are globally getting involved in immunization services as important members of the healthcare team. This study aimed to determine barriers, and assess challenges and possible opportunities to provide immunization in the Lebanese pharmacy practice.

METHODS

This was a cross-sectional study that included pharmacists from all over Lebanon, as part of a national research to assess the role of pharmacists as immunizers. All registered pharmacists in Lebanon practicing in community, hospital, or other clinical settings were considered eligible for participation. A web-based self-administered validated questionnaire, which is initially developed by the American Pharmacists Association, was adapted with permission.

RESULTS

A total of 315 pharmacists responded to the survey. Only 23.1% declared completing an immunization training program. Over half of pharmacists (58.4%) administer vaccines to patients. A significant association between lack of support from physicians to pharmacists (adjusted odds ratio [ORa] = 2.099, 95% confidence interval [CI] = 1.290-3.414,  = 0.003) and vaccine administration was found, while cost associated with professional development and additional training (ORa = 0.533, 95% CI = 0.287-0.989,  = 0.046) was inversely associated to it. Logistic, financial, and legislative requirements as essential necessities were determined to successfully expand pharmacist-led immunization services.

CONCLUSIONS

The major barriers and challenges to vaccine administration by pharmacists comprised a lack of physicians' support and expenses associated with professional development and additional training. Pharmacists administer more vaccination despite lack of support from physicians; whereas they administer less vaccination due to cost associated with professional development and further training. The scope of pharmacy practice in Lebanon is not well recognized by other healthcare providers and stakeholders to include immunization services.

摘要

背景与目的

由于免疫接种覆盖率仍低于目标水平,疫苗可预防疾病仍然是全球卫生关注的重点。国家计划强调多学科努力和方法在疫苗接种计划中的重要作用。药剂师作为医疗团队的重要成员,正在全球范围内参与免疫接种服务。本研究旨在确定黎巴嫩药房实践中提供免疫接种的障碍,评估挑战和可能的机会。

方法

这是一项横断面研究,纳入了来自黎巴嫩各地的药剂师,作为评估药剂师作为免疫接种者角色的全国性研究的一部分。黎巴嫩所有在社区、医院或其他临床环境中执业的注册药剂师均被视为有资格参与。一份基于网络的自我管理的有效问卷,最初由美国药剂师协会编制,经许可进行了改编。

结果

共有315名药剂师回复了调查。只有23.1%的药剂师宣称完成了免疫接种培训项目。超过一半的药剂师(58.4%)为患者接种疫苗。发现医生对药剂师缺乏支持与疫苗接种之间存在显著关联(调整后的优势比[ORa]=2.099,95%置信区间[CI]=1.290-3.414,P=0.003),而与专业发展和额外培训相关的成本(ORa=0.533,95%CI=0.287-0.989,P=0.046)与之呈负相关。确定后勤、财务和立法要求是成功扩大药剂师主导的免疫接种服务的必要条件。

结论

药剂师进行疫苗接种的主要障碍和挑战包括缺乏医生的支持以及与专业发展和额外培训相关的费用。尽管缺乏医生的支持,药剂师仍进行更多的疫苗接种;而由于与专业发展和进一步培训相关的成本,他们进行的疫苗接种较少。黎巴嫩药房实践的范围未得到其他医疗服务提供者和利益相关者的充分认可,未将免疫接种服务纳入其中。

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