Pharmacist Immunization Initiative

1
Pharmacist Immunization Initiative

• LCDR Keith Olin
• CDR Michael Shiber

2
Overview

• Professional role
• Traditional practice skill set
• Evolving Trends
• Module
• Example - PharmPAC Immunization Initiative/FOH
  Clinics
• Goals of Initiative
• Training
• Funding
• Outcomes

3
Defining your role?

• Traditional Skill Set
• Daily
• Deployment
• Evolving Trends
• Educational Curriculum
• Professional Organizations
• Congressional

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Pharmacy Category

• Traditional Pharmacists Role
• Review Prescriptions, Dispensing Medications, and
  Counseling Patients
• Emerging Roles
• Pharmaceutical care the goal is to improve an
  individual patients quality of life through
  achievement of definite, medication-related
  therapeutic outcomes.

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Pharmaceutical Care Outcomes

• Cure of a disease
• Elimination or reduction of symptoms
• Arresting or slowing of a disease process
• Preventing a disease or symptoms

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Practice of Pharmacy

• Many Pharmacy Practice Acts include statements
  that give pharmacists the authority to administer
  medication.
• In most states with this authority, this is
  interpreted broadly as administration by any
  route.

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PHS PharmPAC Immunization Initiative

• Background
• 2003 H5N1 virus reported in humans
• November 2005 National Strategy for Pandemic
  Influenza
• Guide for our nations preparedness and response
• May 2006- The National Strategy for Pandemic
  Influenza Implementation Plan
• The plan directs HHS to work with Homeland
  Security
• Priority Mass Vaccination/Preparedness
• February 2007 - The Commissioned Corps Response
  to Hurricane Katrina and Rita

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PHS Immunization Initiative

• Background (Contd)
• 2006 - 44 states allow pharmacists to immunize in
  some manner.
• Some States that do not authorizing pharmacists
  to administer vaccines Maine, New York, West
  Virginia, New Hampshire.
• Puerto Rico and District of Columbia also do not
  have authority granted.

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PharmPAC Immunization Initiative

• Why?
• Pharmacists are a valuable resource
• Advancing pharmacy practice for USPHS Pharmacists
• How?
• Set Goals
• Planning
• Implementation
• Outcomes

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Goals

• To build a surplus of immunizing pharmacists
  capable of participating in mass vaccination
  efforts
• Provide pharmacists the appropriate skills and
  knowledge to administer vaccinations during
  emergencies

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Planning

• 2006 PharmPAC Initiative
• How do we get there
• Evaluate currently trained pharmacists
• Five year timeframe - train remaining USPHS
  pharmacists
• The National Strategy for Pandemic Influenza Plan
• Include smallpox vaccine training

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Planning

• Education
• American Pharmacists Association (APhA)
  Pharmacy-Based Immunization Training A National
  Certificate Training Program for Pharmacist
• Program started in 1996
• Program Overview
• Provide comprehensive immunization education
  training
• Provide pharmacists with skills, resources and
  material
• Identify at-risk patient populations needing
  immunizations
• Maintain immunization records

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Funding

• Where do you start?
• Support
• Licensing agreement from APhA
• Professional Organizations
• Grants
• Professional Schools
• Federal Agencies

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Training

• Offered to all PHS pharmacists (approx.900 active
  duty)
• Train 100 of PHS pharmacists
• Course Locations
• Geographic Locations
• Regional Course
• National Conferences
• USPHS Scientific and Training Symposium
• Faculty Trainers
• Increase the number of PHS faculty trainers
• PHS Pharmacy Officer
• Volunteers

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Training

• Courses offered by the PharmPAC over the past 3
  years
• December 2006 (Maryland)
• 39 pharmacists trained
• June 2007 USPHS Scientific and Training
  Symposium
• 19 pharmacists trained
• September 2007 (Maryland)
• 29 pharmacists trained
• June2008 - USPHS Scientific and Training
  Symposium

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Implementation

• Federal Occupation Health (FOH) Clinics
• Provide training opportunities for trained
  pharmacist and to support the clinics
• Influenza Clinics
• Working in conjunction with the FOH to support
  nurses staff the flu clinics
• Provide in-service clinics for pharmacists
• Prior to start of clinics
• Practice

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FOH Clinics

• Pharmacists are activated by OFRD
• 2006 Clinics
• 20 Commissioned Corps Pharmacists activated
• Locations
• Washington DC/Maryland/Vermont/New York
• 5 sites within these 4 states
• Results
• 45 of immunizations
• 1184 immunizations given by pharmacists

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FOH Clinics

• 2007 Clinics
• 66 Commissioned Corps Pharmacists activated
• October 1st to November 30th
• Mentor program
• Locations
• Virginia/Washington DC/Maryland/Vermont/CT
• 11 separate sites
• Results
• 2175 immunizations given by pharmacists
• Approximately 43 Immunizations

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Continuing Efforts

• FOH Clinics allowed pharmacists who are in
  non-clinical roles the opportunities to maintain
  the skills that they learned during there
  certificate training course
• There are efforts through other agencies to allow
  pharmacists the opportunities to participate in
  influenza clinics
• BOP
• IHS

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Outcomes

• Currently (Reported to the PharmPAC)
• 252 Commissioned Corps Pharmacist Trained
• PharmPAC trained
• BOP trained
• IHS trained
• 28 Faculty Trained Commissioned Corps Pharmacists

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Outcomes

• Certificate Programs
• 2006
• APhA Pharmacy-Based Immunization Training Program
  was the only national recognized certificate
  program by PharmPAC and OFRD
• 2008
• PharmPAC collected data on other additional
  certificate program for pharmacists
• 15 additional equivalent certificate programs
  are now recognized by the PharmPAC and OFRD

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Future Outlook

• Continue to implement 5 year Initiative Plan
• PHS Pharmacists Immunization Listserv
• Allow the PharmPAC to distribute information

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Outlook

• Trends
• 2008 - 48 states allow a pharmacist to give
  vaccinations
• Ohio and West Virginia now allows pharmacist to
  administer additional vaccines besides Influenza
• Pharmacy Schools now offer Immunization Courses
  as part of their curriculum

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QUESTIONS?

• Contact Information
• LCDR Keith Olin
• 301-796-0962
• Email keith.olin_at_fda.hhs.gov
• CDR Michael Shiber
• 202-353-4758
• Email MJShiber_at_bop.gov