IntroductionThe goal of the study was to identify perceived barriers to implementation of vaccination services encountered by independent and small-chain community pharmacies in an urban setting.MethodsPharmacists in independent and small-chain pharmacies located in 29 Michigan ZIP codes were visited and asked to complete a 5- to 10-min semi-structured interview.ResultsA total of 93 independent and 12 small-chain pharmacies participated (n = 105; 61%). The pharmacies filled an average of 700 prescriptions each week with 1.1 pharmacist full-time equivalents and 57 h of technician time. The most common services that participating pharmacies provided were dispensing outpatient medication (99%), medication therapy management (MTM, 65.7%), disease management or coaching (54.3%), point-of-care testing (34.3%), and dispensing medications to inpatient facilities (16.2%). Only seven pharmacies (6.7%) administered vaccinations. When pharmacists were asked to identify what it would take to start to administer vaccines, the most common responses were increased demand from patients (37.1%), adequate time (19%), appropriate space (17.1%), appropriate amount of staff (14.3%), change in attitudes or beliefs of the owner or pharmacists at that pharmacy (13.3%), increased profit related to vaccines (11.4%), and increased awareness among patients about the importance of vaccines (11.4%). The majority of pharmacies (65.3%) reported that only one factor would need to change to start to administer vaccines.ConclusionIndependent and small-chain community pharmacies in an urban, primarily low-income area identified several barriers that have prevented implementation of vaccination services. However, the majority of pharmacies reported that only one factor would need to change in order to begin to administer vaccines. Interventional efforts necessary to address commonly cited barriers may include providing education to pharmacists about the need for community pharmacy-based immunization programs in addition to services provided by physician offices, as well as the importance of proactively providing immunization-related recommendations to patients.

The restructured internship program provided pharmacy students with a 10-week program that exposed them to many aspects of community pharmacy practice. The program needs future refinement and assessment measures to verify interns improve skills throughout the program.

Researchers have identified barriers to providing medication therapy management (MTM) services in the community pharmacy setting. 1 Barriers perceived by pharmacists include the lack of pharmacists' training in the elements of MTM, resources to support the service, and personnel to assist pharmacists in the provision of the service. 1,2Incorporating pharmacy technicians in the process may help to decrease perceived barriers. 2 Not all elements required for the completion of MTM cases require the clinical judgment of a pharmacist. Nonclinical tasks include scheduling patient appointments, making reminder phone calls to patients with appointments scheduled, identifying patients who are eligible for MTM, and performing the final billing steps in order to receive reimbursement. 3 Such nonclinical functions can be designated to a pharmacy technician so that the pharmacist can focus on drug-related problems and conduct more MTM sessions.In order to incorporate technicians into the MTM process, training programs are necessary. The need for edu-