Pharmacy Staff Research Articles

An implementation science focused practice‐based research network for rural community pharmacies: RURAL‐CP

AbstractPractice‐based research networks (PBRNs) support the translation and evaluation of evidence‐based practices and interventions on a large scale and have primarily been used in primary care settings. Few pharmacy PBRNs exist. Our objective is to describe the composition and characteristics of the Rural Research Alliance of Community Pharmacies (RURAL‐CP), which is the first PBRN exclusively for rural community pharmacies. For each enrolled pharmacy, a pharmacist liaison completed a survey that assessed the pharmacy's operational characteristics, including business operations, human resource management, division of clinical responsibilities, technology and enhanced services, organizational context, and research priorities. Additionally, up to five other pharmacy staff members completed a brief survey on organizational context. Descriptive statistics were calculated. As of May 2023, there were 126 pharmacies across seven southeastern states that were enrolled in RURAL‐CP. Most pharmacies (91%) were independent pharmacies and operated 6 days per week (82%). On average, pharmacies employed 10 staff members and most trained student pharmacists. Pharmacies offered valuable services in their community, including immunizations, naloxone dispensing, and medication delivery. Blood glucose testing was the most common point‐of‐care (POC) test offered, and most pharmacies were interested in expanding POC offerings, particularly A1c testing and cholesterol screening. RURAL‐CP pharmacies have, on average, relatively strong organizational contexts and readiness for change. Pharmacists' top research priorities were expansion of clinical services, reimbursement, patient adherence, and addressing diabetes and hypertension. Although not generalizable to all rural pharmacies, results indicate that rural pharmacies deliver many important services in their communities and are interested in increasing services provided.

Evaluation of SARS-CoV-2 Antibody Levels in Pharmacists and Pharmacy Staff Following CoronaVac Vaccination.

The aim of this study was to determine the seropositivity rate of pharmacists and pharmacy staff after the administration of two doses of the CoronaVac-SinoVac vaccine and to assess changes in their antibody levels according to sociodemographic characteristics. This descriptive study was conducted between June 04, 2021 and September 30, 2021 in pharmacies located in Istanbul, Türkiye. The results of self-initiated immunoglobulin (Ig) G testing of the pharmacists and pharmacy staff, conducted at diagnostic laboratories contracted by the Istanbul Chamber of Pharmacists, were obtained using an online data collection tool. IgG measurements taken from 15 days up to 120 days after the two vaccine doses were included in the study. Participants were asked whether they smoked, had any chronic diseases (hypertension, chronic obstructive pulmonary disease, asthma, diabetes, etc.), or took any medications. Subgroup analyses were performed for each method used to measure antibody levels. The study included 329 pharmacists/pharmacy staff (298 pharmacists and 31 pharmacy staff). The mean age of the participants was 49.7 ± 13.7 years, and 71.4% were female. The antibody positivity of the 329 participants was 94.9% following the two doses. The positivity rate was 95.4% in participants under 65 years of age, whereas it was 91.8% in those aged 65 years and over. There was no significant difference in the mean age between those with positive and negative antibody results (p > 0.05). Although antibody levels were lower older people, smokers, and those with chronic diseases, this difference was not statistically significant (p > 0.05). Seropositivity developed following the administration of two doses of CoronaVac-Sinovac vaccines. IgG antibody levels were lower in older adults, smokers, and those with chronic diseases, although not to a statistically significant extent. Further studies are needed to better understand the reasons for the different immunological responses to COVID-19.

Pharmacy Assistance Programs for Oral Anticancer Drugs: A Narrative Review.

Oral anticancer medications (OAMs) are high priced with a significant cost-sharing burden to patients, which can lead to catastrophic financial, psychosocial, and clinical repercussions. Cost-conscious prescribing and inclusion of low-cost alternatives can help mitigate this burden, but cost transparency at the point of prescribing remains a major barrier to doing so. Pharmacy assistance programs, including co-payment cards and patient assistance programs administered by manufacturers and foundation-based grants, remain an essential resource for patients facing prohibitive co-payments for OAMs. However, access to these programs is fraught with complexities, including lack of trained financial navigators, limited transparency on eligibility criteria, onerous documentation burdens, and limits in available funding. Despite these drawbacks and the potential for such programs to incentivize manufacturers to keep list prices high, assistance programs have been demonstrated to improve financial well-being for patients with cancer. The increasing development of integrated specialty pharmacies with dedicated, trained pharmacy staff can help improve and standardize access to such programs, but these services are disproportionately available to patients seen at tertiary care centers. Multistakeholder interventions are needed to mitigate the burden of cost sharing for OAMs, including increased clinician knowledge of financial resources and novel assistance mechanisms, investment of institutions in trained financial navigation services and centralized platforms to identify assistance programs, and policies to cap out-of-pocket spending and improve transparency of rates charged by pharmacy benefit managers to a health plan.

The association between number of learners and pharmacist and technician levels of burnout.

Little is known about the relationship between learner load and pharmacist and pharmacy technician burnout. Therefore, the purpose of this study was to examine the association between burnout and the number of learners (residents, students, and new employees) assigned to pharmacists or pharmacy technicians. A validated survey to measure burnout and professional fulfillment was administered to employees of a university health system's pharmacy service in 2019. A threshold analysis determined the optimal cutoff for number of learners trained that maximized the ability to predict binary outcomes. Chi-square and Fisher's exact tests were used, and effect sizes between percentages were reported. Finally, the adjusted associations between number of learners and outcomes were assessed using logistic regression. A total of 448 pharmacy staff members were included in the analysis. Of those, 57% (n = 254) worked in ambulatory care, 27.4% (n = 122) worked in an inpatient setting, and 15.7% (n = 70) worked in infrastructure. Pharmacists working in an inpatient setting who reported training 4 or more learners per year indicated significantly higher rates of burnout than those training fewer learners on both a single-item burnout assessment (64.3% vs 31.0%; P = 0.01; effect size, 0.68) and a 10-item burnout assessment (54.8% vs 13.8%; P = 0.01; effect size, 0.91). Similar results were not observed in pharmacists working in ambulatory care and infrastructure positions or in pharmacy technicians. Added precepting and training responsibilities may be associated with higher levels of burnout among pharmacy team members, particularly inpatient pharmacists.

Communication skills-based training about medication switch encounters: pharmacy staff and patients' experiences.

Non-medical medication switches can lead to difficult conversations. To support pharmacy staff, a communication training has been developed based on two strategies: 'positive message framing' to emphasize positive elements of the message and 'breaking bad news model' to break the news immediately and address emotions. To assess how patients and trained pharmacy staff experience the application of communication strategies for non-medical medication switch conversations and which are barriers and facilitators for the application. The Kirkpatrick training evaluation model, level 3 'behavior', including barriers and facilitators and 4 'results' was used. Trained pharmacy staff registered switch conversation characteristics and asked patients to complete a questionnaire. Semi-structured interviews with trained pharmacy staff members were conducted. Quantitative data were analyzed descriptively and interview data were analyzed thematically. Of the 39 trained pharmacy staff members, 21 registered characteristics of 71 conversations and 13 were interviewed; 31 patients completed questionnaires. Level 3: trained pharmacy staff self-reported they applied aspects of the strategies, though indicated this was not yet a standard process. Interviewees indicated signs of increased patient contact and job satisfaction. Time, face-to-face conversations and colleague support were facilitators. Level 4: pharmacy staff members were satisfied with most switch conversations (89%), particularly with addressing emotions (74%). Patients were (very) positive (77%) about the communication, particularly about clear explanations about the switch. Pharmacy staff's learned behavior includes being able to apply aspects of the strategies. The training results show first signs of better patient-pharmacy staff relationships and increased job satisfaction.

Community pharmacists' perceptions on managing people with oral health problems-A prioritisation survey.

Alternative sources of oral health information are likely to be of benefit to the public, particularly where access to dental services is limited. There is evidence that community pharmacists are willing to advocate for oral health, but it is unclear what is needed to develop this role. The aims of this study were to obtain the views of community pharmacy staff on the frequency and type of oral health conditions they encounter challenges in management and training/research priorities. An anonymous online survey targeted pharmacy staff and elicited quantitative data related to the types and frequencies of oral health conditions experienced. Participants were stratified by age, gender, ethnicity, experience and setting. Free text responses allowed participants to detail challenging aspects of patient management, their priorities for service development and future research. Reflexive thematic analysis of free text responses identified key themes. Oral/facial pain and swelling were seen weekly by most respondents, and daily by 28.8%. Other commonly presenting conditions were ulcers, dry-mouth, thrush and denture issues. Challenges in managing oral health conditions included: access to NHS dentistry, awareness of referral pathways, examination/diagnosis and understanding 'Red Flags'. Acute and chronic oral health conditions commonly present to community pharmacists who lack necessary knowledge/training, which may result in missing 'red flag' symptoms for oral cancer or acute facial swellings which can be life threatening. There is a need to support pharmacists, who are willing to act as oral health advocates, in recognition, prevention and onward referral for oral diseases.

Co-development and testing of an extended community pharmacy model of service delivery for managing osteoarthritis: protocol for a sequential, multi-methods study (PharmOA)

BackgroundOsteoarthritis is a common, painful and disabling long-term condition. Delivery of high-quality guideline-informed osteoarthritis care that successfully promotes and maintains supported self-management is imperative. However, osteoarthritis care remains inconsistent, including under use of core non-pharmacological approaches of education, exercise and weight loss.Community pharmacies are an accessible healthcare provider. United Kingdom government initiatives are promoting their involvement in a range of long-term conditions, including musculoskeletal conditions. It is not known what an enhanced community pharmacy role for osteoarthritis care should include, what support is needed to deliver such a role, and whether it would be feasible and acceptable to community pharmacy teams. In this (PharmOA) study, we aim to address these gaps, and co-design and test an evidence-based extended community pharmacy model of service delivery for managing osteoarthritis.MethodsInformed by the Theoretical Domains Framework, Normalisation Process Theory, and the Medical Research Council (MRC) framework for developing complex interventions, we will undertake a multi-methods study involving five phases:1. Systematic review to summarise currently available evidence on community pharmacy roles in supporting adults with osteoarthritis and other chronic (non-cancer) pain.2. Cross-sectional surveys and one-to-one qualitative interviews with patients, healthcare professionals and pharmacy staff to explore experiences of current, and potential extended community pharmacy roles, in delivering osteoarthritis care.3. Stakeholder co-design to: a) agree on the extended role of community pharmacies in osteoarthritis care; b) develop a model of osteoarthritis care within which the extended roles could be delivered (PharmOA model of service delivery); and c) refine existing tools to support community pharmacies to deliver extended osteoarthritis care roles (PharmOA tools).4. Feasibility study to explore the acceptability and feasibility of the PharmOA model of service delivery and PharmOA tools to community pharmacy teams.5. Final stakeholder workshop to: a) finalise the PharmOA model of service delivery and PharmOA tools, and b) if applicable, prioritise recommendations for its wider future implementation.DiscussionThis novel study paves the way to improving access to and availability of high-quality guideline-informed, consistent care for people with osteoarthritis from within community pharmacies.

Prioritizing Quality over Quantity: Defining Optimal Pharmacist-to-Patient Ratios to Ensure Comprehensive Direct Patient Care in a Medical or Surgical Unit.

The expanding scope of practice of hospital pharmacists has contributed to improvements in patient care; however, workload remains a barrier to the provision of optimal pharmaceutical care. Established ratios to guide clinical pharmacy staffing on medical and surgical units are lacking in Canada. To determine the pharmacist-to-patient ratio that allows for provision of comprehensive pharmaceutical care to each patient on a medical or surgical unit and to determine which comprehensive care tasks can be delivered in settings where staffing is limited. A multiphase study was conducted in 6 hospitals. First, a modified Delphi study was conducted to define and prioritize the elements of comprehensive pharmaceutical care. Next, a work sampling study was conducted to establish the frequency of each task and the time required for completion. Finally, a workforce calculator was used to determine pharmacy staffing ratios. Ten pharmacists participated in the modified Delphi study, and 31 participated in the work sampling study. A total of 15 comprehensive care tasks were identified, 7 of which were categorized as tasks to prioritize in settings where staffing is limited. The optimal staffing ratios were 1 pharmacist to 13 patients in internal medicine teaching units, 1 pharmacist to 26 patients in hospitalist or internal medicine nonteaching units, and 1 pharmacist to 14 patients in surgical units. The optimal staffing ratios determined in this study should enable pharmacists to provide comprehensive care to each patient. Implementing these staffing ratios could increase the consistency of clinical pharmacy services, improve patient outcomes, and improve pharmacists' work satisfaction. Further research is required to validate these ratios in a variety of settings.

Promotion and COVID-19 lockdown increase uptake of funded maternal pertussis vaccination in pharmacy: A mixed methods study.

To explore the effects of promotion and COVID-19 lockdowns on uptake of funded maternal pertussis vaccination in pharmacy, and awareness, use and opinions of promotional elements. Five years of pharmacy claims data were analysed and 12 pharmacists, 18 people eligible/recently eligible for maternal pertussis vaccination and 11 midwives were interviewed. Provision of maternal pertussis vaccination increased during and after promotion. Qualitative data showed that pharmacists valued phone calls with information about maternal pertussis vaccination and recommendations for increasing uptake. Prompted by these calls, some pharmacists contacted midwives to inform them of funded maternal pertussis vaccination in the pharmacy (which midwives appreciated) and recommended pertussis vaccination to pregnant clients. Pharmacy staff reportedly were motivated to recommend this vaccination by being informed about it and having posters displayed in the pharmacy. Pregnant people valued healthcare professionals' conversations about maternal pertussis vaccination, but appeared to be uninfluenced by posters and promotional social media posts about this vaccination. During COVID-19, maternal pertussis uptake in pharmacies increased 31% March to May 2020 (before and during the first COVID-19 lockdown) versus the same time the previous year, then declined. Promotion appeared to have a sustained effect on uptake of maternal pertussis vaccination in pharmacies. Pregnant people were most influenced by discussions with healthcare professionals. Pharmacists and pharmacy staff increased proactivity with maternal vaccinations after promotion to them. Promotion may need to be repeated over time.

Weight-Based Standardized Sugammadex Dosing in Pediatrics: A Quality Improvement Initiative to Improve Compliance with Dosing Guidelines and Reduce Waste and Cost.

Sugammadex vials were fractionated into 25, 50, or 100 mg aliquots, which would be distributed to anesthesia staff by pharmacy staff in approximate 2 mg/kg of actual body weight doses (±10%). We analyzed changes in sugammadex waste and dosing practices 1/1/2019 to 3/15/2023 pre/postintervention (4/1/2021). We gauged dose appropriateness using last train of four (TOF) prior to sugammadex administration. 7,889 patients 2-17 years (4,771 with documented TOF), ASA 1-4 receiving general anesthesia with a steroidal NMB medication and sugammadex reversal. Pre- and postintervention mean doses were 2.5 mg/kg (SD: 1.2) and 2.4 mg/kg (SD: 0.96), respectively. A smaller proportion of cases received standard 2 or 4 mg/kg doses (pre: 77.6 vs. post: 66.7%). Mean waste per case declined from 4.2 mg/kg (SD: 4.1) to 0.22 mg/kg (SD: 0.38). Among cases with 0 or 1 measured twitches on TOF that should receive at least 4 mg/kg, fewer received at least 3.6 mg/kg (post: 56.7% vs. pre: 66.8%), and a greater proportion received less than 2.2 mg/kg (post: 27.4% vs. pre: 20.7%). Among cases that should have received at least 2 mg/kg by TOF, the proportion of patients receiving more than 3.6 mg/kg declined from 9.5% to 5.2%. Discussion. Fractionating sugammadex vials was associated with decreases in waste, but not dose, and significant underdosing was more likely to occur. While vial fractionation could enable increased access to sugammadex and other costly medications, it may introduce unintended consequences.

How can community pharmacists be supported to manage skin conditions? A multistage stakeholder research prioritisation exercise

ObjectiveTo establish research priorities which will support the development and delivery of community pharmacy initiatives for the management of skin conditions.DesignAn iterative, multistage stakeholder consultation consisting of online survey, participant...

Allow all pharmacy staff to prepare and assemble medication without supervision, says Community Pharmacy Scotland

Allow all pharmacy staff to prepare and assemble medication without supervision, says Community Pharmacy Scotland

Dispensing practices of amoxicillin suspension by community pharmacists

Abstract Background: Amoxicillin suspension is frequently prescribed to children; we hypothesized that prescribing convention system constraints lead to unusual dosing regimens and unnecessary waste of the drug. Objective: Identify antibiotic dispensing practices by community pharmacists and/or technicians to understand opportunities to decrease wasted amoxicillin liquid and optimize prescribing convention of liquid amoxicillin to children. Methods: Pilot online survey of Atlanta area and National Community Pharmacists Association pharmacists or pharmacy technicians that self-reported dispensing amoxicillin suspension. Questions regarding liquid amoxicillin dispensing practices and other open comments were asked about suggestions to decrease amoxicillin waste from March 13 to April 5, 2023. Results: Among 68 pharmacy staff that participated, over 90% reported dispensing extra liquid amoxicillin to patients for more than 10% of the doses they dispensed. Twenty-seven respondents (39.7%) felt that amoxicillin waste was a problem; waste was most often due to package/bottle sizing issues (n = 64 of 67 responses, 95.5%). Respondents reported instructing families to dispose of extra medication in the trash (n = 51, 75%); 11 (16.2%) instructed pour the remaining in the sink; none reported requesting return to the pharmacy, and 6 (8.8%) reported other instructions. Community pharmacists observed that computerized algorithms create odd dosing amounts and that some prescribers add to the overall amount needed routinely. Conclusion: Community pharmacists in this pilot survey observed prescribing conventions, manufacturing, regulatory, and electronic medical record constraints that lead to liquid amoxicillin waste or confusing amounts for families to use.

Using a support and development service to facilitate successful integration of pharmacy staff across a GP federation

Using a support and development service to facilitate successful integration of pharmacy staff across a GP federation

Knowledge, attitudes, and practices of pharmacy staff on cosmetic products in Lomé, Togo.

Knowledge, attitudes, and practices of pharmacy staff on cosmetic products in Lomé, Togo.

Pharmacy Staff's Recommendations for Self-Medication Requests on Non-Infectious Productive Cough: A Study in Padang City, Indonesia

Cough is a physiological reflex to liberate the airway from mucus or foreign objects. Many cough medicines in pharmacies require special expertise to select the proper medication according to the patient's condition. This research aims to evaluation recommendations of drugs for non-productive cough for self-medication from pharmacy staff in Kuranji subdistrict, Padang City. A cross-sectional study with total sampling techniques is used for collecting data. This research uses a structured interview technique with the main question, what medicine would pharmacy staff recommend if an adult patient comes with a productive cough without any symptoms of infection? There are 30 pharmacies in Kuranji subdistrict, but data that meets the inclusion criteria is only from 25 pharmacies because five pharmacies are not willing to be research sites. Those who were willing to take part in this research were 16 pharmacists and nine non-pharmacist staff. Only 37.5% (6 of 16) of correct drug recommendations were given by pharmacists, and 33.3% (3 of 9) of proper drug recommendations were provided by non-pharmacist staff. There are still many things that could be improved in drug recommendations for this case, with a total average of correct administration of only 36%. The proper drug choices were Bromhexin and Acetylcysteine, while other drugs that were incorrectly chosen were drugs that should have been given with a doctor's prescription, branded drugs with more than one active ingredient , herbs or not the drug of choice for now.There are still many mistakes in the medicine choice, with an average total of only 36% accurate recommendations.

Integration of a web application in Osakidetza Basque Health Service information system to optimize and adapt pharmacy therapeutic of multimorbid patients.

Background: Due to population aging and advances in medical science, people with chronic diseases and polypharmacy are living longer. Challenges are how healthcare systems can cope with the cost burden of chronic disease, sustain a quality independent living for patients; and ensure sustainable healthcare and social care systems. Innovative solutions as well as sustainable integrated workforce solutions are emerging as an alternative to tackle this challenge.
 Methods: Within Gatekeeper, the Basque Country region is carrying out a “management of people with chronic diseases and polypharmacy"" quasi-experimental study (non-randomized, concurrent and controlled study). The aim is to assess the effectiveness and experience of using a mobile application (My Treatment) to improve adherence of patients with polypharmacy and boost the optimization of pharmacological prescriptions by using a web platform (CheckTheMeds). This study plans to advance as well in the enhancement of Primary Care teamwork, coordination, and communication to acquire new roles to support each other, and offer holistic care to patients.
 The intervention has been deployed in 11 Integrated Health Organizations of Osakidetza Basque Health Service, Basque Country (Spain). More than 275 healthcare professionals (doctors, nurses, and pharmacy staff) from Primary Care (PC) centers are participating in the intervention. Trained PC healthcare professionals have started the piloting. They have recruited 690 patients who meet the inclusion criteria (65 years of age or older, with 2 or more chronic diseases and 9 or more chronic or on-demand medicines prescribed). The piloting will last until June 2023.
 Results: 690 patients (intervention and control group) have been included in the study. After signing the informed consent, their health status (Barthel test), prescribed drugs (CheckTheMeds platform), and adherence to treatment (Morisky Green test) are completed at baseline and after a 6-month follow-up. Preliminary data extracted from OAS (Oracle Analytics Services) of Osakidetza reflected that the average age of the recruited patients is 77.9 years, and 58% are male. The average prescription of these patients is 13.10 medicines. 51% of the users are independent (Barthel Test) and 80% of the patients are compliant (Morinsky Green test).
 The evaluation is being conducted with a mixed methods approach, integrating quantitative and qualitative techniques, by organizing a workshop (November 2022) and a focus group. 
 Discussion and Conclusions: Improved appropriate polypharmacy, together with adherence to prescribed medication, will result in more effective treatments with fewer PRMs and health complications, and therefore, in improved efficiency in the use of healthcare resources. As a consequence, a better use of resources, increasing coordination, and teamwork among primary care healthcare professionals,s and introduction of new roles can improve the efficiency of health systems. Thus, the coordinated action of healthcare professionals, in close collaboration with the patient, is postulated as a common denominator in strategies aimed at improving adherence to treatment and offering new caring skills. This integrated care model is flexible and can be replicated at large scales in different environments.

OTC SENIOR STATION: CONSUMER-FACING TECHNOLOGY TO PROMOTE MEDICATION SAFETY

Abstract Over-the-counter (OTC) medications with anticholinergic effects (e.g. doxylamine, diphenhydramine) are widely used by older adults, despite their association with an increased risk of Alzheimer’s disease and related dementias (ADRD). Authoritative bodies, such as the American Geriatrics Society and National Academy of Medicine, recommend discouraging the use of both prescription and OTC anticholinergics. However, most interventions previously developed and tested have targeted only prescription anticholinergics despite the use rate of OTC anticholinergics being higher in older adult populations. Consumer-facing technology may be ideal for addressing OTC anticholinergic use as it is cost effective, scalable, and can address the constraints of relying on busy pharmacists to intervene during older adult OTC medication purchases; this has become especially relevant as pharmacies face staffing shortages, increasing pharmacist workload and requiring pharmacies adjust their hours of operation. Our interdisciplinary team of pharmacists, engineers, and designers engaged both older adults and pharmacy staff in the co-design of “OTC Senior Station”: a user-centered, consumer-facing kiosk to be placed in community pharmacies to promote reduced anticholinergic use by older adults. Kiosk users are prompted to input brief information, which is used to present safer alternatives to OTC anticholinergics (e.g., for insomnia management). This poster will present OTC Senior Station--what we believe to be the first consumer-facing technology to target OTC anticholinergic use—the participatory design methods used to create it, and the results of studies to assess its usability with older adults.

Understanding the Information Needs of Pharmacy Staff Using CancelRx: A Qualitative Study of the Use of Prescription E-cancellation

BackgroundAlthough electronic prescription cancellation such as via CancelRx can facilitate critical communication between prescribers and pharmacy staff about discontinued medications, there is little work that explores whether CancelRx meets the needs of pharmacy staff users. ObjectiveThis study leverages qualitative interviews with pharmacy staff to address the following question: When medication changes are made by a prescriber using CancelRx, what information is needed by pharmacy staff to make correct and effective decisions in their roles in medication management? MethodsWe conducted an inductive thematic analysis of interviews with 11 pharmacy staff members (pharmacists and pharmacy technicians) across three outpatient community pharmacy sites within an academic health care system. ResultsThree information needs themes were consistently identified by both pharmacists and pharmacy technicians: prescriber intent when initiating the CancelRx, clinical rationale for the medication change, and intended medication regimen. Notably, both pharmacists and pharmacy technicians often reported seeking multiple information needs not fully addressed by CancelRx in the electronic health record (EHR) to achieve the shared goals of correct dispensing of medications and supporting patient self-management. ConclusionsOur qualitative analysis reveals that outpatient community pharmacy staff in an academic health care system often seek additional information from the (EHR) following medication changes communicated by CancelRx to meet their information needs. Ideally, the prescriber would provide sufficient information through CancelRx to automatically identify all discontinued prescriptions. These limitations highlight the need for design features that support routine communication of needed information at the time of a medication change, such as structured data elements.

Vaccine administration by pharmacy technicians: Impact on vaccination volume, pharmacy workflow and job satisfaction

BackgroundImmunizing pharmacy technicians (IPTs) have become more prevalent in recent years, but their impact on community pharmacy practice has yet to be determined. ObjectivesDetermine the impact of implementing IPTs on vaccination volume in a community pharmacy chain and assess pharmacy staff's perspectives on the clinical abilities of IPTs and their impact on pharmacy workflow and job satisfaction. MethodsRetrospective data analysis comparing the number of vaccines administered in a supermarket pharmacy chain from September to March 2019–2020 and 2020–2021 in pharmacies with IPT(s) versus those without IPT(s). For the secondary objective, investigators developed and deployed two role-based mixed quantitative/qualitative surveys among pharmacy staff. ResultsPharmacies with IPT(s) observed a greater mean increase in vaccination volume from 2019–2020 to 2020–2021 versus those without IPTs (+159.35 vs. +104.57, p = 0.011). Among IPT survey respondents, 50/75 (66.7%) felt more satisfied with their job after receiving immunization training. Among pharmacist respondents, 80/119 (67.3%) felt that IPTs positively impacted their job satisfaction and 61.7% felt that pharmacist clinical services were either somewhat positively affected, or positively affected. ConclusionImplementing IPTs can increase the volume of vaccines administered in a chain pharmacy and may positively affect job satisfaction and pharmacy workflow.