Türkiye’de Eczanede Bağışıklama Hizmetinin Uygulanabilirliği: SWOT Analizi ile Değerlendirme

Yıl 2021, Cilt: 5 Sayı: 2, 99 - 123, 31.12.2021

Zafer Çalışkan

https://doi.org/10.52148/ehta.1029555

Cited By: 1

Öz

Bu çalışmanın amacı, influenza aşılamasının eczaneler üzerinden yürütülerek arttırılması için neler yapılması gerektiğinin araştırılmasıdır. Influenza, hastaneye yatışların ve hatta buna bağlı ölüm riskinin yaygın bir nedenidir. Aşıların; hastalıkları ve enfeksiyon hastalıklarına bağlı ölümleri önlemenin en maliyet etkili yollarından biri olduğu düşünülse de, Türkiye’deki influenza aşılama oranları hedeflerin çok altında kalmaktadır. Eczacıların influenza aşısı yapmasına izin vermek, influenza aşılama oranını artırmaya ve ayrıca aşı tereddütünün üstesinden gelmeye yardımcı olabilir. Bu amaçla, bu çalışmada bir SWOT analizi yapılmıştır. SWOT analizi sonuçları, yetkililerin WO (zayıflık-fırsatlar) stratejilerini uygulayabileceklerini ortaya koymaktadır. Bununla birlikte; analiz sonuçları, eczanelerde aşılamanın daha fazla fırsata (örn.; yetişkinler için aşı kapsamının arttırılması, influenza vakalarının ve hastaneye yatışların azaltılması, maliyet tasarrufu) ve zayıflıklara (örn.; eczacıların aşılama konusunda yetersiz eğitim seviyesine sahip olması, artan iş yükü, advers vakaların yönetimi) sahip olduğunu göstermektedir. Bu çerçevede; Türkiye’de sağlık politikasında kapsamlı bir mevzuat değişikliğine ve aşı uygulayacak eczacıların bu konudaki mesleki yeterliklerini sağlayacak eğitimlere ihtiyaç olduğu ortaya çıkmaktadır.

Anahtar Kelimeler

Bağışıklama, Aşılama, SWOT, influenza, Eczane

Destekleyen Kurum

Sanofi Pasteur

Applicability of Immunization Services in Pharmacies in Turkey: Evaluation Through SWOT Analysis

Öz

The aim of this study is to investigate what has to be done for increasing influenza vaccination through pharmacies in Turkey. Influenza is a common cause of hospitalizations and even the risk of related deaths. Although vaccines are considered to be one of the most cost-effective way of preventing illness and deaths from infection diseases, influenza vaccination rates remain far below goals in Turkey. Allowing pharmacists to administer influenza vaccination may help to increase the rate of influenza vaccination and also to tackle vaccine hesitancy. For this purpose, a SWOT analysis is conducted in this study. SWOT analysis results reveal that the authorities can implement WO (weakness-opportunities) strategies. Results also indicate that vaccination in pharmacies has more opportunities (for example increasing vaccination coverage for adults, decreasing incidence of influenza and hospitalization, cost-saving) and weaknesses (for example; pharmacists’ insufficient education level on vaccination, increased workload, managing adverse events). Within this scope, it emerges that there is a need for a comprehensive legislative amendment in health policy in Turkey and a training to ensure the professional competence of pharmacists who will administer vaccines.

Anahtar Kelimeler

Vaccination, SWOT, Immunization, pharmacy, influenza

Kaynakça

• 1. World Health Organization. (2019). The global vaccine action plan 2011-2020: review and lessons learned: strategic advisory group of experts on immunization.
• 2. Drummond, M., Chevat, C., & Lothgren, M. (2007). Do we fully understand the economic value of vaccines?. Vaccine, 25(32), 5945-5957.
• 3. Jefferson, T. (1999). Do vaccines make best use of available resources? (in other words are they cost-effective?). Vaccine, 17, 69-73.
• 4. Excler, J. L., Privor-Dumm, L., & Kim, J. H. (2021). Supply and delivery of vaccines for global health. Current Opinion in Immunology, 71, 13-20.
• 5. Plotkin, S. A., & Plotkin, S. L. (2011). The development of vaccines: how the past led to the future. Nature Reviews Microbiology, 9(12), 889-893.
• 6. Chang AY, Riumallo-Herl C, Perales NA, Clark S, Clark A, Constenla D, et al. (2018). The equity impact vaccines may have on averting deaths and medical impoverishment in developing countries. Health Affairs (Millwood). 37(2), 316–24.
• 7. Ibuka Y, Paltiel AD, & Galvani AP. (2012). Impact of program scale and indirect effects on the cost-effectiveness of vaccination programs. Med. Dec. Making. 32(3); 442–6.
• 8. Bärnighausen, T., Bloom, D. E., Cafiero-Fonseca, E. T., & O’Brien, J. C. (2014). Valuing vaccination. Proceedings of the National Academy of Sciences, 111(34), 12313-12319.
• 9. Blut A. (2009). Influenza virus. Transfusion Medicine and Hemotherapy. 36(1), 32.
• 10. Zambon MC. (1999). Epidemiology and pathogenesis of influenza. Journal of Antimicrobial Chemotherapy. 44 (90002), 3-9.
• 11. ECDPC (2021). https://eur-lex.europa.eu/legalcontent/EN/TXT/PDF/?uri=CELEX:32018D0945& from= EN#page=24.
• 12. Elçin, İ. Ö. (2002). http://www.thb.hacettepe.edu.tr/arsiv/2002/sayi_1/baslik4.pdf.
• 13. Çelik, A. ve ark. (2018). Kalp yetersizliği ve kronik kalp hastalıklarında erişkin aşılama: Uzman görüşü. Türk Kardiyoloji Derneği Arş. 46(8), 723-734.
• 14. Enfeksiyon Hastalıkları Derneği (2016). 2016-asi-a4rapor kpk.cdr (enfeksiyon.org.tr).
• 15. OECD (2021). Influenza vaccination rates (indicator). doi: 10.1787/e452582e-en.
• 16. https://appsso.eurostat.ec.europa.eu/nui/show.do?dataset=hlth_ps_immu&lang=en.
• 17. International Pharmaceutical Federation (FIP) (2020). An overview of pharmacy’s impact on immunisation coverage: A global survey. The Hague: International Pharmaceutical Federation.
• 18. Akın, L., Macabéo, B., Caliskan, Z., Altinel, S., & Satman, I. (2016). Cost-effectiveness of increasing influenza vaccination coverage in adults with Type 2 diabetes in Turkey. PloS one, 11(6), e0157657.
• 19. Burson, R. C., Buttenheim, A. M., Armstrong, A., & Feemster, K. A. (2016). Community pharmacies as sites of adult vaccination: A systematic review. Human Vaccines & Immunotherapeutics, 12(12), 3146–3159. doi:10.1080/21645515.2016.1215393. 20. Goad, J. A., Taitel, M. S., Fensterheim, L. E., & Cannon, A. E. (2013). Vaccinations administered during off-clinic hours at a national community pharmacy: implications for increasing patient access and convenience. The Annals of Family Medicine, 11(5), 429-436.
• 21. O’Reilly ve ark. (2018). Economic analysis of pharmacist-administered influenza vaccines in Ontario, Canada. ClinicoEconomics and outcomes research: CEOR,10, 655).
• 22. PSI (2016). Patient Feedback on the Flu Vaccination Service Provided in Pharmacies https://www.thepsi.ie/Libraries/Pharmacy_Practice/Report_on_Patient_Feedback_on_the_Flu_Vaccination_Service_Provided_in_Pharmacies.sflb.ashx.
• 23. Finnegan, G. (2019). https://www.vaccinestoday.eu/stories/pharmacy-pilot-project-increases-flu-vaccination-by-32/.
• 24. Taitel, M., Cohen, E., Terranova, B., Baloun, L., Kirkham, H., Duncan, I., & Pegus, C. (2011). Pharmacists as immunization providers: patient attitudes and perceptions. Pharmacy Times, 77(9), 60.
• 25. Loughlin, S. M., Mortazavi, A., Garey, K. W., Rice, G. K., & Birtcher, K. K. (2007). Pharmacist-Managed Vaccination Program Increased Influenza Vaccination Rates in Cardiovascular Patients Enrolled in a Secondary Prevention Lipid Clinic. Pharmacotherapy, 27(5), 729–733. doi:10.1592/phco.27.5.729.
• 26. Steyer TE, Ragucci KR, Pearson WS, Mainous AG. (2004). The role of pharmacists in the delivery of influenza vaccinations. Vaccine. Feb 25; 22(8), 1001-6. doi: 10.1016/j.vaccine.2003.08.045. PMID: 15161077.
• 27. Papastergiou, J., Folkins, C., Li, W., & Zervas, J. (2014). Community pharmacist–administered influenza immunization improves patient access to vaccination. Canadian Pharmacists Journal/Revue des Pharmaciens du Canada, 147(6), 359-365.
• 28. Horta MCS, Mendes T, Mendes Z, Santos C. (2009). Immunization delivery: a new service provided in Portuguese pharmacies. Part II: First Nationwide Influenza Immunization Campaign. FIP Congress; Istanbul, Turkey.
• 29. Nissen, Lisa, Glass, Beverley, Lau, Esther, & Rosenthal, Michelle (2015). Queensland pharmacist immunisation pilot phase 1 pharmacist vaccinaition - Influenza final report.
• 30. Salter S, Singh G, Nissen L, et al. (2021). Active vaccine safety surveillance of seasonal influenza vaccination via a scalable, integrated system in Western Australian pharmacies: a prospective cohort study. BMJ Open, 11:e048109. doi:10.1136/ bmjopen-2020-048109.
• 31. Pedersen, K. M., Bech, M., & Vrangbæk, K. (2011). The Danish Health Care System: An Analysis of Strengths, Weaknesses, Opportunities and Threats (SWOT analysis). University of Southern Denmark: COHERE-Centre of Health Economics Research.;
• 32. Christiansen, T. (2002). “A SWOT analysis of the organization and financing of the Danish health care system”, Health Policy, Vol. 59 No. 2, pp. 99-106.
• 33. Helms, M. M., Moore, R., & Ahmadi, M. (2008). Information technology (IT) and the healthcare industry: A SWOT analysis. International Journal of Healthcare Information Systems and Informatics (IJHISI), 3(1), 75-92.
• 34. Topor, D. R., Dickey, C., Stonestreet, L., Wendt, J., Woolley, A., & Budson, A. (2018). Interprofessional health care education at academic medical centers: using a SWOT analysis to develop and implement programming. MedEdPORTAL, 14.
• 35. Montalban, J. M., Ogbuneke, C., & Hilderman, T. (2014). Vaccine safety: Analyzing and strengthening the vaccine safety program in Manitoba. Canada Communicable Disease Report, 40 (Suppl 3), 31. 36. Uğurluoğlu, Ö., Öztunç, B., Demir, İ. B. ve Ürek, D. (2015). Swot Analizinin Sağlık Kurumlarında Uygulanması. İŞ, GÜÇ" Endüstri İlişkileri ve İnsan Kaynakları Dergisi, 17(1), 193-214).
• 37. Türk Eczacıları Birliği (TEB) (2019). Eczanelerde Ekonomik ve Finansal Durum Araştırması, 2019.
• 38. Küçüktürkmen, B., ve Bozkır, A. (2018). Özel saklama koşulu gerektiren veya soğuk zincire tabi ilaçlar ve uygulamalar açısından değerlendirmeler. Türk Hijyen ve Deneysel Biyoloji Dergisi. Interest Group.