What is the Federal Pharmacists' Role in Adult Immunization? 10/15/2015. CPE Information and Disclosures. Learning Objectives.

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1 CPE Information and Disclosures Public Health Service Breakout Session 2 CDR Shary Jones Office of Assistant Secretary for Health Department of Health & Human Services CDR Karen Williams Health Resources and Services Administration CDR Sheila Ryan Food and Drug Administration CDR Shary M. Jones, CDR Karen Williams and CDR Sheila Ryan declare no conflicts of interest, real or apparent, and no financial interests in any company, product, or service mentioned in this program, including grants, employment, gifts, stock holdings, and honoraria. The American Pharmacist Association is accredited by the Accreditation Council for Pharmacy Education as a provider of continuing pharmacy education. CPE Information Learning Objectives Target Audience: Pharmacists ACPE#: L04-P Activity Type: Knowledge-based 1. Identify four areas of improvement within respective organizations/practices to advance adult immunization rates based on the National Adult Immunization Plan. 2. Describe the functions of the National Vaccine Injury Compensation Program, including its liability protections for health providers. 3. Explain how to leverage partnerships to increase the flow of information to older populations via social media. Learning Objectives What is the Federal Pharmacists' Role in Adult Immunization? CDR Shary M. Jones LCDR Maggie Zettle Office of the Assistant Secretary for Health, Department of Health and Human Services 1. Identify four areas of improvement within respective organizations/practices to advance adult immunization rates based on the National Adult Immunization Plan. 1

2 Self-Assessment Question 1 Self-Assessment Question 2 What vaccines would a female patient, 60 years of age, be likely to receive? (assuming no special risk groups, contraindications and ACIP recommendations are followed) A. Tdap or Td only B. Tdap or Td, influenza and zoster C. Tdap or Td, influenza, and PPSV23 D. Tdap or Td, influenza, zoster, and PPSV23 KD is a pharmacist in a physician collaborative clinic. The clinic stocks influenza, varicella, and both pneumococcal vaccines. A diabetic patient wanted to know how they can be protected against shingles. What is KD s role? A. Assess, recommend, administer, document B. Assess, recommend, refer, document C. Educate, recommend, refer, document D. Educate, recommend, administer, document Self-Assessment Question 3 Adult Immunization Schedule What is the target percentage of surveyed pharmacies that submit adult vaccination data to an IIS, according to the National Adult Immunization Plan? A. 20% B. 40% C.60% D.80% Adult Immunization Schedule Standards for Adult Immunization Practice Assess Recommend Administer or Refer Document 2

3 Standards for Adult Immunization Practice Standards for Adult Immunization Practice Draft National Adult Immunization Plan Goals: 1. Strengthen the Adult Immunization Infrastructure 2. Improve Access to Adult Vaccines 3. Increase Community Demand for Adult Immunizations 4. Foster Innovation in Adult Vaccine Development and Vaccination Related Technologies Where do pharmacists fit? Goal 1, Objective 4: Increase the use of Immunization Information Systems and Electronic Health Records to collect and track adult immunization data. Goal 2, Objective 3: Expand the adult immunization provider network. Where do pharmacists fit? How will we measure? Goal 3: Objective 1: Educate and encourage individuals to be aware of and receive adult immunizations. Objective 2: Educate and encourage healthcare professionals to recommend and/or deliver adult vaccinations. Objective 3: Educate and encourage other groups (e.g., community and faith based groups) to promote the importance of adult immunization. Indicators Each goal has measurable indicators Annual reporting Infographic dashboard Will be housed on the NVPO website 3

4 Measuring pharmacists Key Points Indicator Baseline Target Percentage of surveyed pharmacies that submit adult vaccination data to an IIS 25% 60% Percentage of adult health care providers who have identified an adverse event following immunization and reported it to VAERS Percentage of states and territories that allow pharmacists to administer all routinely recommended vaccines for adults % In development 85% 100% The Department of Health and Human Services recognizes the impact pharmacists have in improving vaccine uptake. Several national plans encourage pharmacists involvement in immunization. Pharmacists have an important role in the public health infrastructure, regarding vaccine preventable diseases. Answers To Self-Assessment Question 1 Answers To Self-Assessment Question 2 What vaccines would a female patient, 60 years of age, be likely to receive? (assuming no special risk groups, contraindications and ACIP recommendations are followed) A. Tdap or Td only B. Tdap or Td, influenza and zoster C.Tdap or Td, influenza, and PPSV23 D.Tdap or Td, influenza, zoster, and PPSV23 KD is a pharmacist in a physician collaborative clinic. The clinic stocks influenza, varicella, and both pneumococcal vaccines. A diabetic patient wanted to know how they can be protected against shingles. What is KD s role? A. Assess, recommend, administer, document B. Assess, recommend, refer, document C. Educate, recommend, refer, document D. Educate, recommend, administer, document Answers To Self-Assessment Question 3 What is the target percentage of surveyed pharmacies that submit adult vaccination data to an IIS, according to the National Adult Immunization Plan? A. 20% B. 40% C. 60% D. 80% Closing Remarks CDR Shary M. Jones Office of the Assistant Secretary for Health, Region VII shary.jones@hhs.gov 4

5 Learning Objectives Overview of the National Vaccine Injury Compensation Program CDR Karen C. Williams, MBA, PharmD, BCNSP U.S. Department of Health and Human Services Health Resources and Service Administration Healthcare Systems Bureau Division of Injury Compensation Programs 2. Describe the functions of the National Vaccine Injury Compensation Program, including its liability protections for health providers. Self-Assessment Question National Vaccine Injury Compensation Program (VICP) Which of the following is not a VICP covered vaccine? 1) Tetanus (Td) 2) Herpes Zoster (shingles) (HZV) 3) Hepatitis A (HAV) 4) Rubella (MMR, MR, R) Background Media reports of adverse reactions following DTP vaccines Increase in lawsuits Withdrawal of manufacturers resulting in vaccine shortage Demand for national solution National Childhood Vaccine Injury Act of 1986 enacted Created the VICP in 1988 Required Vaccine Information Statements (VIS) Purpose Compensate individuals injured by certain vaccines Ensure a stable vaccine supply VICP 3 parts of the Federal government have a role in the VICP Department of Health and Human Services (HHS) Department of Justice (DOJ) US Court of Federal Claims (Court) Covered vaccines: Recommended by CDC for routine administration to children Have an excise tax imposed The Court decides: whether a claim is compensated the type and amount of compensation Attorneys fees and cost Anyone, regardless of age, may file a claim For more information, visit: Countermeasures Injury Compensation Program (CICP) The CICP provides compensation to individuals injured by covered countermeasures. Covered countermeasures include certain U.S. Food and Drug Administration approved vaccines, drugs and devices used to prevent, treat or diagnose: 2009 Pandemic H1N1 Influenza Smallpox Anthrax Botulism Ebola Acute Radiation Syndrome 5

6 Key Points Answers To Self-Assessment Question The VICP established to provide compensation to individuals thought to be injured by certain vaccines. Vaccines not covered by the VICP Certain non-seasonal flu vaccines are not VICP-covered vaccines Pneumococcal polysaccharide vaccine (PPSV, PPV) Herpes zoster (shingles) vaccine The CICP provides compensation to individuals injured by covered countermeasures. Which of the following is not a VICP covered vaccine? 1) Tetanus (Td) 2) Herpes Zoster (shingles) (HZV) 3) Hepatitis A (HAV) 4) Rubella (MMR, MR, R) Herpes Zoster (shingles) vaccine is not recommended for routine administration to children by the CDC Closing Remarks CDR Karen C. Williams, MBA, PharmD, BCNSP Division of Injury Compensation Programs Healthcare Systems Bureau Health Resources and Services Administration Phone: kcwilliams@hrsa.gov USPHS GERIATRICS PHARMACY TEAM Sheila Ryan, PharmD CDR, US Public Health Service (USPHS) US Food and Drug Administration Learning Objectives Presentation Overview 3. Explain how to leverage partnerships to increase the flow of information to older populations via social media Background on Geriatrics Objective for the Team Areas of Focus History of the Team Completed Projects Future Plans 6

7 Self-Assessment Question Why Focus on Geriatrics? How many baby boomers (born ) currently live in the US? A: 70,000 B: 700,000 C: 7 million D: 77 million 2015 marks the 50 th Anniversary of the Older Americans Act 45% of the US population is >50 77 million baby boomers (born ) By 2030, 1 out of 5 people in the US will be >65 In 2050, the number of Americans >65 = 88.5 million (double the population in 2010) Objective of the Group Areas of Focus Increase awareness of issues related to medications and older patients To healthcare providers To patients To caregivers Increase USPHS collaboration with other pharmacy and patient organizations Mixing alcohol with medications Fall Prevention Other medication issues Alcohol and Medications Alcohol use frequently overlooked in older adults Population at risk for alcohol/medication interactions 78% of drinkers >65 use medications that can interact with alcohol Heavy drinkers 5.6% years 3.9% years 4.7% years Some common medications for these patients contain up to 10% alcohol (laxatives, cough syrup) Alcohol/Medication Effects Aging slows down ability to break down alcohol Women at higher risk than men for issues Intensify medication side effects Decreased concentration, drowsiness, lightheadedness Increased risk of accidents, falls May decrease effects of other medications Increase risk of complications Liver damage, heart problems, internal bleeding, impaired breathing, depression 7

8 Fall Prevention General Medication Concerns Pharmaceutical Ask: alcohol use Educate: medications that can interact Switch: BEERS list Lifestyle modifications Increase exercise Remove tripping hazards from home Regular eye and hearing exams Medication Abuse 12-15% of elderly individuals Opiates and stimulants Polypharmacy Persons >65 age account for 1/3 of total outpatient spending on prescription medications Almost 30% of adults 45 to 64 and >50% of adults >65 suffer from two or more chronic conditions Increased risk of drug interactions Target Audiences Patients Older Americans (baby boomers and up) Healthcare Providers Pharmacists Prescribing authorities Caregivers Children, grandchildren, spouses, nursing home staff Methods Gathering resources Collaborating with other patient-centered organizations Educating via Social Media Contributing to articles and policy documents Coordinating with other public health initiatives White House Conference on Aging Fall Prevention Awareness Day (Sept) American Pharmacists Month (Oct) Older American Month (May) Completed Projects National Council on Patient Information and Education (NCPIE) Feb 2015: Project Advisory Meeting Assist in plan development for reaching older adults via social media White House Conference on Aging 50 th Anniversary in July 2015 Gathered information Distributed messages via Twitter in conjunction with Conference Drafted potential content for Pharmacy Today interview with CPO Challenges Narrowing objectives Coordinating and networking Internal External Time commitment Quick deadlines 8

9 Future Plans Expand messaging and topics Weekly Tweets Coordinate with PharmPAC Social Media Team and SG Coordinate with other public health initiatives/ organizations: Fall Prevention Awareness Day (Sept) American Pharmacists Month (Oct) Continue work with NCPIE Article contributions Members LT Ofir (Noah) Nevo (FDA) CAPT Angela Payne (FDA) CDR Sheila Ryan (FDA), Lead LCDR Jennifer Shepherd (FDA) LCDR J. Garrett Sims (IHS) CDR Roney Won (IHS) Sources Answer to Self-Assessment Question How many baby boomers (born ) currently live in the US? A: 70,000 B: 700,000 C: 7 million D: 77 million Closing Remarks CDR Sheila Ryan Sheila.ryan@fda.hhs.gov