在学生主导的跨专业诊所增加一名免疫药剂师对服务不足人群的影响

Khyati Patel, Danielle Candelario, Ateequr Rahman, Melissa Chen
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摘要

背景:为了在流感高峰期简化我们每周由学生主导的免费跨专业社区诊所(ICC)的工作流程,从2018年10月到2019年2月,我们增加了一名药剂师轮班,专门负责提供免疫服务。本研究的目的是确定在临床药剂师之外增加一名免疫药剂师对遵守疾病控制和预防中心(CDC)疫苗建议和ICC总体免疫率的影响。方法:回顾性分析2017年10月至2019年2月患者就诊情况。当没有安排免疫药剂师时,将疫苗接种率和CDC推荐依从性与历史对照进行比较。对分类资料进行卡方分析;Fisher的精确测试被用来评估免疫药剂师对疫苗接种率和对CDC建议的依从性的影响。p值为0.05)。结论:在跨专业诊所实施免疫药剂师可显著影响疾病预防控制中心推荐的肺炎球菌疫苗的依从性,但不显著影响总体疫苗接种率。应权衡增加一名专门从事疫苗接种的药剂师的好处,以改善工作流程,而不是对疫苗依从性和比率的影响。
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Impact of an Additional Immunizing Pharmacist at an Interprofessional Student-led Clinic for the Underserved
Background: To streamline workflow during peak influenza season in our weekly student-led free Interprofessional Community Clinic (ICC), an additional pharmacist shift solely responsible for providing immunization services was implemented from October 2018 to February 2019. The objective of this study was to determine the impact of adding an immunizing pharmacist, in addition to a clinical pharmacist, on adherence to Centers for Disease Control and Prevention (CDC) vaccine recommendations and overall immunization rates at ICC. Methods: A retrospective chart review of patient visits from October 2017 to February 2019 was conducted. Vaccination rates and CDC recommendation adherence were compared to a historical control when an immunizing pharmacist was not scheduled. Chi-square analysis was performed on categorical data; Fisher’s exact test was used to assess impact of an immunizing pharmacist on vaccination rates and adherence to CDC recommendations. A p-value of <0.05 was considered statistically significant.  Results: A total of 78 patient visits and 58 unique patients were included. There was a significant increase in the adherence to CDC recommendations for pneumococcal vaccine when an immunizing pharmacist was present (p=0.02). There was no significant difference in the adherence to CDC recommendations for all other vaccines and overall vaccine rate between the two groups (p>0.05).  Conclusion: Implementation of an immunizing pharmacist in an interprofessional clinic significantly impacts the adherence to CDC recommendations for pneumococcal vaccine without significantly impacting the overall vaccine rate. Benefit of an additional pharmacist dedicated to vaccinations should be weighed for workflow improvement versus impact on vaccine adherence and rate.
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