Magazine article Drug Topics

Adding Another Responsibility: Public Health

Magazine article Drug Topics

Adding Another Responsibility: Public Health

Article excerpt

Some have embraced their new roles while others express reservations

Forget about simply filling prescriptions - today's community pharmacists have moved from behind the counter to the front lines of healthcare delivery.

Armed with additional education and an industry push to move past what some have described as the "count, pour, lick, and stick" approach to retail and communitybased pharmacy, many pharmacies across the country have adopted new policies and procedures that focus more on patient care and outcomes.

One of the most notable of these changes is the authority pharmacists now have to administer vaccinations to their patients. All 50 states, as well as Puerto Rico and the District of Columbia, now give pharmacists the right to administer influenza vaccines, and some states allow other types of vaccination as well.

According to the American Pharmacists Association (APhA), more than 100,000 pharmacists nationwide have qualified as immunizers through the association's training program. It is estimated that in 2009 pharmacists administered more than 16 million doses of vaccines.

During an online survey conducted in May, Drug Topics found that 54% of the 254 pharmacists responding to the poll were planning to become certified to vaccinate, while 41 % said that their employers were not requiring them to obtain certification.

This new responsibility has been embraced by some professionals as a tangible way to demonstrate the value pharmacists can provide in the healthcare arena, but others have expressed reservations about adding vaccination to the menu of services their pharmacies already offer.

Such reservations can range from concerns about incurring additional liability to frustration that pharmacists are being asked to do more for no additional compensation.

The road to immunization

APhA Chief of Staff Mitchel C. Rothholz, RPh, said that the idea of bringing vaccination to the community pharmacy began back in 1 994 during a conversation that took place between association leadership and Donna Shalala, then serving as Secretary of Health and Human Services.

Shalala wanted to increase the vaccination rate among Americans and she saw local pharmacies as one means by which this might be accomplished, since pharmacists already possess medical knowledge and are accessible in locations convenient for most patients.

Since then, APhA has been working hard to advocate for legislation that gives pharmacists the authority to administer vaccinations at retail and community store settings. It also created an extensive training program that educates pharmacists about vaccinations used throughout the lifespan and offers hands-on experience in administering injections.

Pharmacists can serve as complementary providers of immunization, Rothholz said. In some cases, because of their extended hours and increased accessibility, pharmacies may be more convenient for patients than traditional medical offices.

"Pharmacists are just like other providers within the community, so when they are doing immunizations they are not doing them any differently than a nurse in the community does it, but we are a permanent access point for the public, versus clinics that may show up and then they are done for the day and move on," he said.

Putting training into practice

Joel Giles, PharmD, the clinical coordinator for King Soopers and City Market Pharmacy Services, said that his company was one of the early pioneers in immunization in the state of Colorado when it began offering patients flu and pneumococcal vaccinations in 2002.

Now all the company's pharmacists are trained to give vaccinations, and the company has continued to expand the types of vaccines it offers.

Immunization is not only a new revenue source for pharmacies, he said. It also serves a critical role in public health.

"It has really advanced the profession," Giles said. …

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