Pharmacists as vaccinators: An analysis of their experiences and perceptions of their new role.

OBJECTIVES: In 2012, Ontario pharmacists were granted immunization privileges to administer influenza vaccines to the public. This study explored the experiences and practices of pharmacist vaccinators and the impact of vaccination pain on their practice. METHODS: Semi-structured interviews were conducted with 12 pharmacists in the Greater Toronto Area. Transcribed interview data were coded and analyzed via thematic analysis. KEY FINDINGS: Data analysis revealed 4 main themes: 1) expanded scope of practice as an enhancement and challenge to relationships; 2) professional satisfaction and workload demands; 3) knowledge and attitudes regarding pain and fear; 4) practices regarding pain and fear management. Pharmacists reported satisfaction in their new role, despite the associated increased workload. Pharmacists felt that vaccination pain was not a key consideration when administering vaccines and that pain management was generally not necessary. Fear was identified as more important than pain and vaccinating children was challenging and time intensive. Pharmacists' main focus was on injection techniques in managing pain. CONCLUSION: These findings suggest that pharmacists are accepting of their role as vaccinators but more research is needed to examine impact on workload and pharmacist knowledge and perceptions of injection-related pain and fear.

Experience with a pill-swallowing enhancement aid.

Barriers to swallowing tablets and capsules can impact adherence to medication regimens. Few tools are currently available to assist adolescent children who have difficulty swallowing tablets and capsules. A convenience sample of adolescent children, identified through selfreport as having difficulty in swallowing tablets or capsules in the past, were provided Pill Glide, a flavored spray promoted to aid swallowing. To emulate medication administration, a tic tac (candy) was placed in the middle of the tongue, and with a drink of water, the participant was instructed to swallow the tic tac. Success or failure to swallow the tic tac was recorded. A total of 11 adolescent children ranging in age from 9 to 17 years reported past difficulty with swallowing medication. Seven of the 11 participants were successful in swallowing the tic-tac with the use of Pill Glide. This initial assessment of Pill Glide spray demonstrates positive findings for improving the ease of swallowing tablets and capsules for adolescents.

Comparison of oral versus normal and high-dose rectal acetaminophen in the treatment of febrile children.

OBJECTIVES: To compare the defervescent effect of high-dose rectal suppository acetaminophen with the recommended oral and rectal dosages and to evaluate acceptability of rectal acetaminophen. METHODS: A randomized, controlled trial was performed in 70 patients aged 6 months to 6 years with fever > or =39 degrees C. Group A received rectal acetaminophen 15 mg/kg, group B received rectal acetaminophen 30 mg/kg, and group C received oral acetaminophen 15 mg/kg. Primary outcome was maximal change in temperature during the 3-hour study period after initial treatment. RESULTS: There were 24 patients in group A, 23 in group B, and 23 in group C. There was no significant difference in temperature change between the groups during the 3 hours or in the maximum drop in temperature or final temperature. Visual analog scores for satisfaction of parents did not reveal any significant differences between the oral and rectal routes. CONCLUSIONS: There was no difference between the temperature decrement in patients treated with 15 mg/kg oral acetaminophen and the same or double dose rectally. Thus, there seems to be no evidence to support the use of higher doses of rectal acetaminophen for the treatment of fever in children. The rectal route proved to be as acceptable as the oral among parents.