30. Impact of Pharmacist Assertiveness Training in Recommending Pneumococcal Vaccination among High-Risk Adults

Abstract

BackgroundCommunity pharmacies have become vital access points to provide a range of vaccines to adults, including pneumococcal; however, despite growth in vaccines given at these sites, the most recent rates of adults being immunized against pneumococcal disease remain below goals set by Health People 2020. A lack of patient awareness is a leading reason for low vaccination rates, suggesting that a need exists to improve provider communication in recommending pneumococcal vaccination in high-risk adults.MethodsA multi-phase, pharmacy-based intervention was launched in west and middle Tennessee locations of a nationwide community pharmacy chain focusing on improving evidence-based, presumptive recommendations related to pneumococcal vaccination. All locations were randomized to one of three arms based on training intensity: 1) no training; 2) online training only; and 3) online and live simulation training. The program focused on providing assertive recommendations and managing potential hesitancy guided by multiple health communication theories and community-based hesitancy data provided to each pharmacy by the study team. Primary endpoints included changes in pneumococcal vaccinations (counts over 6-month periods [July-December] in 2018 and 2019) and provider vaccine-related self-efficacy and were evaluated by generalized linear models.ResultsA total of 100 pharmacies were enrolled and 50 pharmacists completed their assigned training element. Completing the full training program (i.e., online and live) led to improvements in pharmacist self-efficacy related to being influential in vaccine-related decisions and not being helpless in managing resistance (both p< 0.05). Overall counts of all pneumococcal vaccines were lower (-11.3%) across all stores in the period following training; however, a small increase (2.1%, P=0.084) was observed in the stores that underwent the full training, versus decreases of 22.0% and 9.4% in control and online-only training comparisons, respectively.ConclusionResults suggest that provider vaccine self-efficacy can be improved through an evidence-based communication training program but substantial improvements in specific vaccinations may need to leverage a more holistic focus on all recommended adult vaccines.Disclosures Justin Gatwood, PhD,MPH, AstraZeneca (Grant/Research Support)GlaxoSmithKline (Grant/Research Support)Merck & Co. (Grant/Research Support) Tracy Hagemann, PharmD, GSK (Grant/Research Support)Merck (Grant/Research Support)