Antiviral Therapies to Improve Patient Outcomes and Reduce Influenza-Related Complications: Impact on Focused Education for Health-System and Community-Based Pharmacists

Symptoms of influenza can range from mild fatigue to respiratory failure requiring hospitalization, which can be fatal among both adults and children. Treatment with antiviral medications has shown to reduce severity of illness, lessen duration of disease, and prevent influenza-related complications in high-risk patient populations. Pharmacists are essential in identifying patients at high risk of severe disease and engaging them in discussion about transmission, symptoms, and ways to reduce the spread of influenza, therefore necessitating targeted community and health system-focused pharmacist education. Based on identified knowledge gaps, multiple educational initiatives were developed to increase confidence and knowledge of pharmacists interacting with patients in these specific pharmacy practice environments.

Educational Strategy:

PTCE developed 4 distinct live virtual programs that launched between 2020 and 2021 for pharmacist learners practicing in community and health-system pharmacy settings. First, a 0.75-credit hour live, interactive, virtual broadcast as part of a community and health-system practitioner meeting series geotargeted to 4 distinct areas across the United States in 2 different years. Second, a 1.5-credit hour live virtual symposium at a large professional organizational meeting in 2 sequential years. One activity featured counseling videos based on real-life scenarios of patient-centered pharmacist care. Videos highlighted education for important points of therapy selection and influenza management that may be appropriate for different high-risk patient case scenarios. Each program was endured for on-demand access following the live programs. The educational objectives across the programs were as follows: (1) Identify the patient populations at greater risk for influenza-related complications, (2) Differentiate current CDC, IDSA, and American Academy of Pediatrics recommendations for the use of antivirals for specific influenza seasons, (3) Examine the clinical and safety evidence for antivirals in the treatment and prevention of influenza virus, and (4) Illustrate the roles of community and health system-based pharmacists in making clinical recommendations and in educating patients about antivirals. Pharmacist baseline knowledge and confidence were assessed through a pretest. Additionally, baseline demographic data were collected and included primary practice setting and years in practice. After completing the activity, pharmacists completed a posttest and confidence questions, and selected planned practice changes.

Patient-Level Outcome(s) Measured:

A of total 15,511 pharmacist learners participated in the live and enduring activities. Practice settings included 8987 (58%) community or retail, and 4219 (27%) health-system pharmacies. 67% to 76% of learners interacted with high-risk patients weekly. 

Correlating pre- and post-assessment questions matched to learning objectives focused on identifying patient populations at greater risk for influenza-related complications and showed a mean relative knowledge increase of 36%. Questions on clinical and safety evidence of influenza antivirals demonstrated a mean knowledge increase of 74%. Case-based questions on pharmacists’ roles in educating patients demonstrated a mean knowledge increase of 87%.

Pre-activity, a mean of 55% (31%-68%) of learners identified themselves as moderately, very, or extremely confident in counseling patients on influenza treatment and prophylaxis compared with 90% post-activity (P < 0.001). The most frequent changes pharmacists intended to implement were sharing therapy recommendations with patients and proactively identifying patients who are at high risk for complications.

Pharmacists demonstrated increased knowledge, competence, and confidence following these activities. Education focused on pharmacist-specific roles is necessary to manage diverse needs, thus enhancing patient outcomes. Initiatives focused on use of innovative videos and offered different learning designs applicable to multiple practice settings. Additional analysis to evaluate individual learners across multiple programs for gains in knowledge and confidence and longitudinal trends are in progress. Educational gaps and future objectives gleaned from outcomes include specific nuances of selection of treatment based on patient-specific factors, emphasizing the appropriate role of prophylaxis with oral antivirals, and differences among products for pediatric patients.