The impact of a pharmacist-extender training program to improve pneumococcal vaccination rates within a community chain pharmacy

Abstract

ObjectivesEvaluate the impact of a targeted training program for pharmacist-extenders (technicians and pharmacy interns) on vaccine screening role expansion within pharmacy workflow on pneumococcal vaccination rates. Secondary objectives include measuring changes in pharmacist-extenders’ role perceptions surrounding vaccination services before and after training and exploring the implementation of vaccine screening role expansion of pharmacist-extenders using semistructured interviews founded in the Consolidated Framework for Implementation Research constructs. DesignThis study used a mixed methods sequential explanatory design from November 2017 to April 2018. Setting and participantsThe study occurred in 20 pharmacies in a division of a national supermarket, community pharmacy in Tennessee. Pharmacist-extenders, who worked in participating pharmacies and who completed the vaccination training program, before or after online survey or interview were included in this study. Outcome measuresPharmacist-extenders accessed a training program webinar. Onsite training focused on identifying eligible patients for pneumococcal vaccines based on patient age and comorbidities. The vaccine screening program used a train-the-trainer model. Pneumococcal vaccination rates were collected and analyzed from January 2018 to March 2018 and compared during the same time period from the previous year. Descriptive and inferential statistics evaluated pneumococcal vaccination rates and survey responses. An anonymous electronic Likert-type scale questionnaire was e-mailed to participating pharmacies before and after the training program. An explanatory qualitative arm was added post-hoc to provide insights into the primary endpoint. Six semistructured interviews were conducted using Consolidated Framework for Implementation Research domains. ResultsPneumococcal vaccination rates improved compared with the previous year during the same time period (P > 0.05). Subgroup analysis identified outlier pharmacies prompting the explanatory qualitative arm. No statistically significant changes were identified in the surveys. Seven themes were identified from participant interviews. ConclusionPneumococcal vaccination rate data showed varying trends toward pharmacist-extenders having a positive impact on pneumococcal vaccination rates through role expansion; however, these improvements varied by pharmacy and were dependent on program implementation differences.