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<td><h1><a name="h1" id="h1"></a>Health Care Delivery </h1>
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<h2><a name="head1">Community pharmacists can increase flu vaccination rates among nonelderly adults</a></h2>
<p>About 20,000 Americans die from influenza each year. Influenza vaccine is recommended for people younger than 65 with chronic heart or lung disease or diabetes, who unfortunately have the lowest rates of vaccination. One reason for low influenza immunization rates is missed opportunities&#8212;that is, people who saw a doctor in the last year but were not vaccinated. Community pharmacists can help to fill this gap, concludes a study supported in part by the Agency for Healthcare Research and Quality (HS10021). </p>
<p>The researchers found that pharmacists authorized to administer influenza vaccines were able to identify adults at risk for influenza by their medication prescriptions for chronic diseases such as asthma and motivate them to be vaccinated. In fact, this practice among pharmacists in Washington State was associated with a net increase of 11 percent in influenza vaccinations among nonelderly adults. </p>
<p>In 1999, John D. Grabenstein, Ph.D., of the University of North Carolina, Chapel Hill, and colleagues mailed a survey to adults in urban Washington State, where pharmacists administered vaccines, and to adults in urban Oregon, where this was not the practice. Thirty-two States have regulations that authorize pharmacists to administer medications.</p>
<p>Among nonelderly adults who were not vaccinated against influenza in 1997, the 1998 influenza vaccination rate was 35 percent in Washington compared with 24 percent in Oregon. The pharmacist-based program in Washington administered 2.3 to 8.4 times as many influenza vaccine doses as Oregon pharmacies that hosted nurses for 1 day in autumn 1998 to offer influenza vaccination. This study of typical vaccination practices is one of the few studies to report vaccine acceptance rates among nonelderly adults with chronic health conditions. Previous studies found influenza vaccine coverage levels of 14 to 39 percent among nonelderly adults in high-risk populations compared with the 58 to 66 percent vaccine coverage in this study. </p>
<p>See "Effect of vaccination by community pharmacists among adult prescription recipients," by Dr. Grabenstein, Harry A. Guess, M.D., Ph.D., Abraham G. Hartzema, Pharm.D., Ph.D., and others, in the April 2001 <em>Medical Care</em> 39(4), pp. 340-348. </p>
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