Friday, March 3, 2017

Improving Expanded Immunization Uptake Using SHARPS methodology

It is a fact of life that people will oppose immunization because of several reasons, some of which are borne out of hearsay, which are of course baseless in themselves, and other concerns are firmly rooted in religious beliefs, cultural background, together with personal experiences, and of those of friends or family members. For the most part, the general population has limited knowledge and information regarding immunization and vaccines. They are in need of good old education. It’s not only fair, but it’s the right thing to do. Patients need information and who else to come to their aid other than their trusted community Pharmacists. As Pharmacists, we are  uniquely positioned to help address concerns of patients in our immediate sphere of influence regarding healthcare matters. We are currently in uncharted territory where immunization is common place and the access to which is largely unhindered. They are trying to make sense of the disease states we are trying to protect them from in the first place. In order to address these disparities and barriers certain concepts must be understood first.
Pharmacists need to acquire an unparalleled level of information regarding immunization and their disease states. For example, we need to be able to articulate to our patients what Shingles is and how it can present and be contracted, why pneumonia shots are recommended for a certain age group, etc.

Firstly, we need to ask ourselves the question; What do Adult patients want to know when it comes to immunization? Examples of such are:
1)    How likely am I to get this disease?
2)    How serious could this disease be for me?
3)    What are the side effects?
4)    How much will it cost me?
Since adults are rational patients and of course more curious than their younger counterparts, effective communication is key! It is imperative to deploy the most effective communication tool to address their concerns, questions, and comments.
a)    Stress the importance of timely immunization;

1)    Highlight susceptibilities
2)    Explain severity and potential cost of getting the disease
3)    Use empowering messages and highlight the benefits of vaccination. Getting vaccinated is part of staying healthy
4)    Provide transparent and plain language information on the disease states and the immunization protocols available.
5)    Finally, tailor information to your audience. Ensure your messages highlight the benefits that support your efforts

S Share: The information shared here should be tailored to your audience, highlight why vaccination is right for the patient given age, health status, lifestyle, job or other risk factors. We need to ensure we share this information at a level where the majority of our captive audience can understand and relate.
H Highlight positive experiences with vaccines to reinforce benefits and strengthen confidence in vaccination. Sometimes you may want to call on own experiences with immunization or share some of the experiences that have been shared with you. Sometimes you may have a patient nearby trying to shed negative light on the act of immunization. It’s not your job to try to make this person understand. The best you can do is to  step back and don’t engage in a conversation, approach your target patient at a later time
A Acknowledge & address the patients questions and any key concerns about vaccine generally and side effects in plain language that can understood. Be that as it may, many a patient have several questions and concerns about immunization period. Your best ally here is sound education. With the advent of the internet, a lot of pharmacy patrons use the internet tools such as Google as a resource. Ensure the information you are providing is true. Patients  are always in search of unadulterated pure information to help them make an informed decision regarding this and other healthcare decisions
R. Patients need to often be reminded that vaccination is not only to protect them from diseases, but to protect their loved ones who will be affected if the patient becomes infected. With this in mind,  adult patients are more likely to buy into the idea of getting vaccinated to protect their grandchildren and other family members
P Price: Explain the potential cost of getting the vaccine and the cost of not getting it. Since most seniors are on a fixed limited income, cost of immunization will arise, such as;
 1} Is this covered by Medicare Part B or D?
2} What will my copay be?
3}  Are there manufacturers coupon that can be leveraged to further lower my copay?
S Support after immunization is key to building a lasting relationship with our patients beyond the pharmacy counter. This level of support is integral to showing empathy and be tailored to each patient. It is customary for a follow up phone calls to patients after immunization to address any concerns/questions they may have. It is vitally important for your patients to know you care and are always available.
As pharmacist, its incumbent upon us to search the internet and use our relationships to help lower the out of pocket cost for our patients. This will definitely help improve the uptake in adult immunization.

 Efforts To Improve Uptake
1} To further get patients and staff engaged, you could provide novelty gift items to patient and the support staff that has the highest number of referrals. The intra-team rivalry is very healthy to ensuring team members are truly committed to this cause. Try to figure out what your patients will like and present as a gift for immunization, examples include pens, stress balls, etc.
2} Partner with the local practitioners in your neighborhood to help spread the word and provide support.
3} Provide pictorial printed materials they can peruse even after leaving the pharmacy. Invest in some brochures that address concerns the patients may have. It is always valuable to address concerns upfront before they are asked
4} Ensure to have a space that is convenient to facilitate immunization, it’s important to have an area in the pharmacy that is carved out for immunization to provide some level of privacy. Patients don’t appreciate other people looking at them as they get vaccinated, or as they solicit further information regarding immunization.
5} Leverage your relationship with manufacturers of vaccines to help with outreach programs. Work with the neighborhood nursing homes, medical facilities to organize a rally that will bring seniors together where you can share vital information.
These are proven efforts that will help you improve expanded immunization in your sphere of practice…./.

Author: Dr. Leke Agbejule

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