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[Approach to upgrading pharmaceutical care: the example of immunization].

AIM
This article describes an approach to upgrading pharmaceutical care in healthcare facilities.


METHODS
This is a descriptive study supporting the upgrade of pharmaceutical care in the field of immunization [blinded for review], in a 500-bed mother-child university hospital. Our approach consisted of 3 steps: (1) a review of the literature, (2) a description of the profile of the sector and (3) a description of upgrading of pharmacists' practices in immunization.


RESULTS
A total of 19 articles were reviewed. No specific pharmaceutical activity based on very good quality data was identified (A).However, eight pharmaceutical activities based on good quality data (B) or with an insufficient level of proof (D) related to immunization practices were identified. A review of pharmaceutical activities (2013-2014) accounted for an annual expenditure of $ CAN 4,227 for vaccines compared to $ SCAN 27,633,944 for all drugs. A total of 9,254 doses of vaccines were prescribed for 3,544 patients. The planned revision of immunization activities includes a medication reconciliation process targeting immunization requirements, systematic consultation of pharmacy dispensing records for patients hospitalized for more than one month to ensure adherence to the Quebec Immunization Protocol, systematic reporting of vaccine adverse reactions, and implementation of information reviews about new vaccines.


CONCLUSION
Few data are available concerning the impact of pharmacists in immunization. This descriptive study proposes a number of steps designed to upgrade pharmaceutical practices in a university hospital.