Conversations between pharmacists and patients reveal factors behind pneumococcal vaccine hesitancy

Researchers at the University of Alberta examined conversations between pharmacists and patients before and after an educational intervention to learn why some people reject recommended pneumococcal vaccines and how pharmacists can assist with vaccine uptake.

“Knowing why individuals do or do not choose to get vaccinated can be really important in meeting patients where they are and providing them with the best information possible. informed decision” says Danielle Nagy, a doctoral student in the School of Pharmacy and Pharmaceutical Sciences and co-author of a study investigating the causes of pneumococcal formation Vaccine rejection.

Paper It was published inside Journal of the American Pharmacists Association.

Because of the health consequences that pneumococcal infections can have in older adults, pneumococcal vaccination is recommended for all adults over the age of 65. But only 58% of Canadians in that span have been vaccinated; This was well below the Public Health Agency of Canada’s 80% target.

Pharmacists play a key role in providing vaccines because they are accessible in communities and have a broad scope of practice. Previous studies have also shown that pharmacist intervention can improve vaccine uptake among patients. The missing piece, Nagy says, is more information about why some eligible people forgo the pneumococcal vaccine.

In the study, which was part of an ongoing research project to develop and test an intervention program aimed at improving pneumococcal vaccine uptake that could be easily adopted in community pharmacies, researchers tested the impact of an educational intervention designed to improve pharmacists’ knowledge and promotion skills. Vaccine. They found that patients gave different reasons for refusing the vaccine before and after the intervention; This showed that patient-pharmacist conversations became more effective in addressing the various factors behind vaccine hesitancy.

“Vaccination and immunization is a huge role we play in public health,” says Darius Ramrattan. undergraduate student Participating in research as part of their community pharmacy assignment. “As someone who is on the front lines right now, I can see the impact of this type of work in pharmacies.”

Participating pharmacies received a toolkit that included an educational video Nagy created, key points to address some common concerns voiced by patients, and document templates to ease the administrative burden on pharmacists. Because of diversity pneumococcal vaccines Existing toolkits also included a decision tree to help pharmacists determine the most appropriate vaccine for each patient.

“With a decision tree, the pharmacist can say: ‘Here’s the person sitting across from me. Based on what I’ve gleaned from them, these are the specific vaccines we’re going to recommend, and here are the strengths and weaknesses of each,'” explains Professor Scot Simpson, President of the Patient Health Management Foundation and principal investigator of the study.

“We really wanted a comprehensive set of tools that could be applied in a variety of community pharmacy settings across the state,” adds Nagy.

Researchers analyzed 656 conversations between pharmacists and patients at 13 pharmacies in Alberta to test the toolkit’s effectiveness and identify common rejection factors that pharmacists could address in their conversations.

The three main reasons for refusal cited by pharmacists in their interviews with patients were lack of perceived benefit, cost, lack of time, or need for more time to think about the decision.

The rate of vaccine rejection due to lack of perceived benefit decreased significantly from 9.4% to 4.7%.

“This really highlights once again the importance of pharmacists in health promotion, especially in terms of administering vaccines and providing that education to patients,” Nagy says. “And it underscores that these conversations we have with patients can really influence an individual’s decision.”

It was rejected after the educational intervention due to increased cost, but the researchers explain that this is because patients have become more aware of all the vaccine options available to them, as some varieties of the pneumococcal vaccine are free at the pharmacy, but not out-of-pocket costs. other healthcare settings. These patients may have continued to receive the vaccine even though it was not available at the pharmacy.

“For the main project that this study is a part of, we used state vaccination registries so that we can identify that a person has received the vaccine no matter where they received it,” Nagy adds.

To address cases of rejection due to lack of time, the toolkit encouraged pharmacists to take a proactive approach, identifying and contacting patients who would benefit from the vaccine.

“People coming in this way would be prepared to spend more time interacting. pharmacist” says Simpson.

Next steps include rolling out the toolkits to an additional 40 to 50 pharmacies to prove the educational intervention is effective on a larger scale. The researchers also note that there may be opportunities to expand the concept to target other proposed vaccines to increase uptake.