Education Is Key to Engaging Patients to Update Their Immunization Status

Most of our patients in the community pharmacy setting are aware that vaccinations are a part of what we offer in our pharmacies. A lot of them are interested in making sure they are up-to-date and will ask us which vaccines we recommend. Others will want a flu shot every year and that’s about it.

We all know the importance of vaccines to our communities and to our business. We need to protect our patients and our communities against many vaccine-preventable diseases. However, most people view getting a shot as something they do not like. As pharmacists, we are not used to suggesting products or services that our patients have no interest in when they came to see us. Therefore, how do we promote our services and protect our communities (and enhance our profits) without coming across like pushy salesmen?

EDUCATION IS KEY

The above question was posed by the author to Pam Patterson, patient care services manager for Albertson’s/Tom Thumb in Dallas, Texas. Patterson’s answer was simple and straightforward: “Education is the key. Your patients must understand why you are suggesting certain vaccines and how it will benefit them.”

Patients know they need a tetanus shot if they step on a rusty nail, but do they know they need one if they are digging in the soil in their garden or if someone in the family is about to have a baby? Most persons with asthma know they need to be up-to-date on their pneumococcal vaccine, but do diabetic patients know that a pneumococcal vaccine is recommended for them, too? Are food service workers aware that they should consider the Hepatitis A vaccine? It is our job to seek out these patients and explain to them why they need certain vaccinations that we can provide to them. We can provide a great service to our communities by identifying these patients and protecting them with the appropriate vaccinations.

PATIENTS TRUST THEIR PHARMACIST

We need to use this trust to help raise vaccination rates in our communities. When we pull them aside to educate them on certain vaccinations, they listen. They may not immediately act on our recommendation, but they will remember it and perhaps implement our advice later. However, it can be hard to convince someone they need a shot and have them spontaneously agree to do so. With persistence, and education, we can convince them to eventually bring themselves current on all the vaccines they need.

PERSISTENCE PAYS OFF

How do we continue to speak with patients about immunizations without overdoing it? The answer is to make these conversations part of a routine. This can take the form of a question at drop off, just like asking for a date of birth or medication allergy, or it can be a standard question at the register. When patients come in for their yearly flu shot, you should always ask if they are up-to-date on all applicable vaccines. This is always a good time to check back in to see if they have followed up on the recommendations you discussed the previous year. Figure out what works best for your pharmacy, discuss it with your staff, and make a plan.

USE YOUR TEAM

This is another excellent idea. Your pharmacy technicians need to be familiar with most recommendations so they can help you identify patients’ needs. Tell them to ask anyone over 50 if they have received their shingles vaccination. They also can identify patients 65 or older and inquire about their status for pneumococcal vaccines. In many cases, your technicians may know the patients better than you do and will be able to identify important vaccines that are related to their profession or lifestyle. The technician can then refer that patient to speak with you regarding a specific recommendation. Having your entire team involved can be very effective in building your immunization practice.

WELLNESS WEEKS

One program that Patterson is very proud of is the Wellness Weeks featured by her Albertsons/Tom Thumb stores. The idea is to feature one type of vaccine during the week and promote awareness of it. This can be supported by signage throughout the store, handouts at the pharmacy, and promotions on the in-store radio system. Starting conversations during a wellness event gives you a good reason to target specific patients without the worry that you may be overdoing it. You can then follow up as necessary. Albertsons/Tom Thumb has taken this idea a step further by teaming with vaccine manufacturers to assist in furthering the message. The manufacturer can provide promotional materials, signage, and commercials over the in-store radio network.

SHARE APPROACH

The SHARE Approach was developed by the Agency for Healthcare Research and Quality to assist health care providers in communicating with patients.¹ It provides you with an easy-to-remember acronym to help you hit all the necessary points when speaking with patients and can easily be applied to assist patients in making decisions about vaccines. The figure1 displays all the steps for you.

BARRIERS TO SUCCESS

There can be a lot of reasons that you may not have success engaging patients for immunizations. The most prominent one, in a lot of cases, is that you feel you do not have time in your workday to make the extra effort promoting vaccines. In our fast-paced pharmacies, time is so important. How quickly can you work? What do you do with the extra minutes you earn by being efficient? Try asking if each patient is up-to-date on their vaccines when you counsel. This takes advantage of the oneon- one time you already have with the patients. They also may be more open to listening because they are already prepared to talk to you about their medication. Have your technicians set the stage for you, so the patients will not feel ambushed by your suggestions.

Some patients are afraid of needles and avoid any kind of shots, including vaccines. Speaking with a reluctant patient about technique and advances in needle technology may help in this situation. If not, education about the disease you are trying to prevent will be your No. 1 resource. Therefore, use handouts provided by manufacturers or by your employer. If you do not have these, check the CDC website. The CDC provides many patient-ready handouts that you can readily print and give to your patients. Maybe you can find a few that you like and keep a small supply on hand to distribute when needed.

Lastly, you will run into patients who are suspicious of vaccines and scared of potential adverse reactions. This is where you can talk about the history of vaccines, their success rates, and safety profiles. Someone who does not trust vaccines might be surprised by some facts about the success of vaccines against ancient diseases like smallpox or polio. Education does not always work, but it is your best weapon against the uninformed patient.

KNOW YOUR VACCINATION RECOMMENDATIONS

The adult vaccine schedule changes from time to time. It is important that you stay up-to-date on all changes that the Advisory Committee on Immunization Practices (ACIP) recommends. The ACIP portion of the CDC website is loaded with information concerning immunization schedules and recommendations. You may also access the schedules pertaining to certain disease states or childhood vaccinations.²

There are many ways to engage patients to stay up-to-date on their vaccines. Remember that education, persistence, and expertise displayed by the pharmacist and pharmacy staff are your best tools to use in running a successful immunization program at your pharmacy.

REFERENCE

1. The SHARE approach. Agency for Healthcare Research and Quality website. ahrq.gov/professionals/education/curriculum-tools/shareddecisionmaking/index. html. Accessed June 19, 2017.

2. Immunization schedules for adults. CDC website. cdc.gov/vaccines/schedules/ easy-to-read/adult.html#print. Updated February 6, 2017. Accessed June 19, 2017.

Unless otherwise attributed, the statements and opinions of this article represent the viewpoints and expertise of the author.

Brady Cole, RPH, is pharmacy manager at Tom Thumb Pharmacy in Plano, Texas, and an active preceptor with Texas Tech University in Lubbock, Texas, and the University of Houston, also in Texas. He is also founder of the website Helpful Pharmacist, www.helpfulpharmacist.com.