Updated Vaccination and Screening Recommendations for Hepatitis B: Implications for Pharmacists.

The number of new infections of hepatitis B is rising and a large number of cases are undiagnosed. These factors are contributing to hepatitis B-related liver complications, including liver cancer, and deaths that could be prevented. The Advisory Committee on Immunization Practices (ACIP) and the Centers for Disease Control and Prevention (CDC) recently updated vaccination and screening/testing recommendations for hepatitis B. The updated recommendations remove the need for risk assessment before screening or vaccination. Pharmacists will play a key role in a concerted national effort to implement these updated recommendations. A multistakeholder Advisory Council convened by the Hepatitis B Foundation identified key barriers to screening and vaccination. The Council also formulated strategies to optimize implementation of the updated recommendations. These strategies include educating pharmacists about the new recommendations and how they will help to reduce the burden of hepatitis B and liver cancer. Pharmacists could explore establishing pharmacy-provider collaborative practice agreements and potentially leverage capacity built with COVID-19 vaccine implementation. Hospital systems and other clinic settings could update their electronic health records to include prompts for hepatitis B vaccination and screening. Pharmacy systems can implement different reminder options to help patients complete the hepatitis B vaccine series. To address a lack of vaccine confidence, pharmacists can emphasize the cancer prevention benefit of hepatitis B screening and vaccination and engage with patients on an individual level to understand their concerns, assess vaccine status, and discuss vaccine recommendations. Effective implementation of the new recommendations will help achieve national and global goals of eliminating hepatitis B as a public health threat by 2030.

Establishment and evaluation of scalable COVID-19 vaccine clinics at a large university.

BACKGROUND: Previous large-scale vaccination clinics have been successful before the coronavirus disease 2019 (COVID-19) pandemic; however, owing to the strict storage requirements and pharmaceutical preparation needed for the COVID-19 vaccines, careful thought and planning were necessary to successfully deploy these clinics immediately after vaccine availability. The focus of this manuscript is to describe the development and implementation of COVID-19 vaccination clinics in a large public university, using professionals from within and outside of its health sciences schools. OBJECTIVES: The primary objective of this project was to (1) implement COVID-19 vaccination clinics for university faculty, staff, students, and community members. Additional objectives of the clinics were to (2) actively incorporate pharmacy, nursing, and medical students into the clinic workflow; (3) promote interprofessional collaboration among faculty and students; and (4) assess patient satisfaction. PRACTICE DESCRIPTION: The School of Pharmacy faculty, in conjunction with the Office of Strategic Initiatives, planned and coordinated COVID-19 vaccination clinics from December 2020 to July 2021. Students and faculty from schools of pharmacy, nursing, and medicine were used. COVID-19 vaccinations were offered to university faculty, staff, and students and community members based on the Centers for Disease Control and Prevention priority groups. The clinic processes were designed such that they could be scaled from 100 to 2,000 participants per day. PRACTICE INNOVATION: The School of Pharmacy led approach was adjustable depending on the number of patients, continuously monitored and adaptable. The importance of pharmacists as part of the interprofessional health care team was exemplified by faculty and students involved. EVALUATION METHODS: All patients receiving COVID-19 vaccinations at the clinics were e-mailed anonymous surveys for assessment of the quality of the vaccination encounter after completion of their primary vaccine series. RESULTS: More than 15,000 COVID-19 vaccinations were provided through the clinics from December 2020 to July 2021. Professional staffing totaled 3352 hours for the 48 clinics. Thirty-eight percent of the vaccinated patients responded to the clinic satisfaction survey with predominately excellent ratings. CONCLUSION: COVID-19 vaccination clinics can be successfully planned and implemented in a scalable fashion in a large university setting using an interprofessional team approach.

Impact of naloxone education for patients receiving buprenorphine-containing prescriptions indicated for opioid use disorder at an independent community pharmacy.

OBJECTIVES: A pilot study was conducted to identify whether an opioid education and naloxone distribution (OEND) service affected (1) willingness to accept naloxone; (2) naloxone dispensation; and (3) patient knowledge about opioids, overdose symptoms, and naloxone in patients receiving buprenorphine prescriptions for opioid use disorder (OUD). METHODS: Participants were enrolled from January 2, 2019, to February 15, 2019, in this prospective noncontrolled study when receiving a buprenorphine prescription at the study site. The exclusion criteria included prescriptions being picked up by someone other than the patient and those who were below 18 years of age. The participants completed a written pre- and postsurvey containing "Yes" or "No," "Select all that apply," and open-ended questions assessing (1) willingness to accept naloxone and (2) change in opioid and naloxone knowledge. RESULTS: Fifty-two participants were enrolled, and all completed the pre- and postsurveys. After the education, there was a not statistically significant change in the proportion of participants willing to accept naloxone from the pharmacy (28.8% vs. 36.5%; P = 0.31). In addition, there was an improvement in the proportion of participants believing that they need to carry naloxone with them (15.4% vs. 40.4%; P < 0.001). Naloxone dispensing increased 400% after the intervention implementation. Improvements in opioid knowledge also occurred. More participants correctly identified buprenorphine as an opioid (48.1% vs. 86.5%; P < 0.001), and correctly identified that methamphetamine (19.2% vs. 3.8%; P = 0.02) and cocaine (17.3% vs. 3.8%; P = 0.03) are not opioids. Of the 52 participants enrolled, 11.5% correctly identified all opioids on the presurvey, whereas 50% correctly identified all opioids on the postsurvey. CONCLUSION: Patients diagnosed with OUD who are prescribed buprenorphine may be at high risk of an overdose if they return to use; yet, few OEND programs specifically target this population. This study suggests that OEND based in community pharmacies may be a strategy to increase naloxone access among these patients.

Development of coupled patient care experience courses to enhance patient care skills in the ambulatory and acute care settings.

BACKGROUND AND PURPOSE: Providing opportunities to allow pharmacy students to apply clinical skills is essential to ensure that they are comfortable and competent to perform these skills during advanced pharmacy practice experiences (APPEs) and in practice. We describe unique coupled courses that require students to apply clinical skills during real patient encounters and simulation activities in the ambulatory and acute care setting to ensure that they are ready for APPEs. EDUCATIONAL ACTIVITY AND SETTING: New required courses were developed at West Virginia University School of Pharmacy that focused on teaching and reinforcing patient care skills in the ambulatory and acute care settings. Both courses were designed to provide students with multiple opportunities to offer supervised patient care and to become more comfortable and confident in their patient care skills. FINDINGS: The coupled courses were well-received by students. Feedback indicated that students felt more comfortable in these patient care settings and in performing patient care activities as a result of these courses. SUMMARY: These coupled courses offered multiple opportunities for students to practice patient care skills and gain valuable experience participating in activities that increased their confidence and competence at being integral members of the healthcare team. The interactions with real patients, simulated patient scenarios, standardized patients, and other members of the healthcare team helped students advance communication skills, clinical skills, and ability to identify and resolve medication-related problems in preparation for APPEs.

Adolescent Vaccines: Current Recommendations and Techniques to Improve Vaccination Rates.

With multiple vaccines for adolescents recommended, it is imperative providers remain up to date with the current recommendations. With misinformation of vaccine safety and effectiveness in the mainstream media and social media, adolescents are a vulnerable population that needs to be reviewed and educated. Adolescents are typically only just starting to take ownership of their health care. Consequently, they may represent a more vulnerable population in need of education. This article reviews the current guidelines, recommended vaccinations and schedules, and methods to improve compliance rates.

Assessment of targeted automated messages on herpes zoster immunization numbers in an independent community pharmacy.

OBJECTIVES: To evaluate the impact of an automated phone call by a pharmacy owner on the number of herpes zoster vaccinations given in the independent community pharmacy setting, compare herpes zoster immunization numbers in the 3 months during the previous year to the 3 months during the intervention, and assess patient satisfaction with the automated phone call service. METHODS: This prospective study took place in an independent community pharmacy. A message was recorded by the pharmacy owner using a telephone-message program that notified patients aged 60 and older that the herpes zoster vaccine is recommended for them. This message was sent out monthly for a total of 3 months. Patients who received this vaccine in the 3 months following the initial phone call were surveyed to determine their reason for receiving the vaccine, and to assess satisfaction with the phone call. The total number of herpes zoster immunizations given at the pharmacy during the study period was compared to the total given at the pharmacy during the same period of the previous year. RESULTS: A total of 25 participants received the herpes zoster vaccine at the pharmacy during the study period, compared to 16 during the control period. Receiving the phone call was the most commonly cited reason for receiving the vaccine, followed by doctor recommendation. Of the 18 participants who received the call, 12 stated that they would be very likely to respond to similar phone calls in the future. CONCLUSION: These results demonstrate that using a targeted, automated phone call directed at eligible patients appears to have a positive effect on their willingness to receive the herpes zoster vaccine and may lead to an increase in vaccination numbers among eligible patients. Various factors must be considered before implementation of this service, including cost and added call volume.

The impact of medication synchronization on quality care criteria in an independent community pharmacy.

OBJECTIVES: To determine the impact of a comprehensive medication synchronization program in an independent community pharmacy by (1) evaluating changes in Electronic Quality Improvement Platform for Plans and Pharmacies (EQuIPP) scores and (2) examining the change in monthly prescription volume. SETTING: Independent community pharmacy in Morgantown, WV. PRACTICE DESCRIPTION: Waterfront Family Pharmacy is a single-location independent community pharmacy located in Morgantown, WV. The pharmacy consists of four full-time pharmacists and is the primary practice site for one community pharmacy PGY-1 resident. The pharmacy provides a variety of clinical services, including vaccine administration, medication therapy management, and diabetes education services. PRACTICE INNOVATION: In September 2014, Waterfront Family Pharmacy started a comprehensive medication synchronization program. EVALUATION: Change in Electronic Quality Improvement Platform for Plans and Pharmacies (EQuIPP) scores and change in monthly prescription volume. RESULTS: At the end of 6 months there was improvement in all targeted EQuIPP scores. There was a 7% improvement in proportion of days covered (PDC) for cholesterol-reducing agents, a 9.5% improvement in PDC for oral glycemic agents, a 1.2% improvement in PDC for renin-angiotensin system antagonists, and a 1.8% reduction in the use of high-risk medications in the elderly. There was also an average increase in monthly prescription volume of 4.8% over the first 6 months after the implementation of the comprehensive medication synchronization program. CONCLUSION: The implementation of a comprehensive medication synchronization program in an independent community pharmacy may result in benefits including improved EQuIPP scores and increased prescription volume.