Uptake of Travel Health Services by Community Pharmacies and Patients Following Pharmacist Immunization Scope Expansion in Ontario, Canada.

Sherilyn K D Houle,Heidi V J Fernandes,Kristina Kozlovsky,Zahava Rosenberg-Yunger

doi:10.3390/pharmacy7020035

Sherilyn K D Houle, Heidi V J Fernandes + Show 2 more

Open Access

https://doi.org/10.3390/pharmacy7020035

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Abstract

In December 2016, pharmacists in Ontario, Canada with authorization to administer injections saw an expansion in their scope from a restriction to the influenza vaccination only to now including an additional 13 vaccine-preventable diseases, largely those related to travel. It was uncertain whether this change in scope would see sufficient uptake, or translate to a corresponding expansion in other travel health service offerings from community pharmacies. In October/November 2017 a survey was conducted of all licensed community pharmacists in Ontario, followed by semi-structured interviews with 6 survey respondents in June 2018. A web-based survey of members of the public from a single region of the province was also conducted in September 2018 to assess uptake of expanded vaccination services. Broad variability in uptake of these services was noted, ranging from the dispensing of travel-related medications and vaccinations only through to vaccine administration and prescribing under medical directive; however, uptake was generally at the lower end of this spectrum. This was evidenced by 94% of pharmacists reporting administering fewer than 10 travel vaccinations per month, fewer than 10% of patients reporting receiving a travel vaccine administered by a pharmacist, and a maximum of 30 pharmacies (of nearly 6000 in the province) designated to provide yellow fever vaccinations. Fewer than 1 in 3 pharmacists reported performing some form of pre-travel consultation in their practice, often limited to low-risk cases only. Barriers and facilitators reported were similar for these services as they were for other non-dispensing services, including insufficient time to integrate the service into their workload, perceived lack of knowledge and confidence in travel health, and low patient awareness of these new services available to them through community pharmacies.

Highlights

This study reported that pharmacists were able to identify and order missing vaccinations that were indicated for patients outside of just travel vaccinations [14]
The objective of this study is to examine data available to date on the landscape of travel health services in Ontario community pharmacies following this change in scope, pharmacists’
Through the triangulation of multiple data sources, this study identified that the uptake of travel-related services by community pharmacies in Ontario has been generally slow, with some variation by activity and by pharmacist, since an expansion in scope to allow for the administration of travel-related vaccines in December 2016

Summary

Introduction

Of note, this legislation only authorizes the administration of each vaccine, with some still requiring a prescription as indicated in the table [3]. Vaccines currently on Ontario’s routine immunization schedule [5] can be obtained at no charge from a physician office or public health clinic; any of these vaccines received in a pharmacy must be paid for by the patient, as well as any administration fee that may be charged by the pharmacy. Some patients may be eligible for coverage through private insurance, this varies by insurer and by vaccine

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