CARD (Comfort Ask Relax Distract) and community pharmacy vaccinations: Evaluation of implementation outcomes from a...

Area of Science:

• Implementation science
• Vaccine delivery protocols
• Patient experience research

Background:

• The Comfort Ask Relax Distract (CARD) system is a protocol designed to enhance the vaccine delivery experience.
• Existing vaccine delivery methods may not adequately address patient anxiety and coping.
• Improving patient coping can lead to better vaccination experiences and potentially higher vaccine uptake.

Purpose of the Study:

• To evaluate the implementation outcomes of the CARD system in community pharmacies.
• To assess the acceptability, feasibility, and impact of CARD on healthcare providers and vaccine recipients.
• To determine if implementation strategies effectively supported the integration of CARD into routine practice.

Main Methods:

• A pragmatic hybrid effectiveness-implementation cluster randomized trial involving 25 community pharmacies.
• Pharmacies were randomized to either the CARD system or usual care (control).
• Implementation strategies included webinars, customized recommendations, change equipment, online groups, audit/feedback, and educational outreach. Provider surveys, focus groups, administrative data, and recipient feedback were used.

Main Results:

• Provider surveys and focus groups indicated high acceptability and feasibility of the CARD system and its implementation strategies.
• Vaccinators in CARD pharmacies reported greater satisfaction with patient interactions and found the system time-neutral.
• Administrative data showed 96% utilization of the CARD coping checklist, with 90% of recipients providing post-vaccination feedback.

Conclusions:

• The CARD system is an acceptable and feasible protocol for community pharmacies.
• Implementation strategies were effective in supporting the integration of CARD into practice.
• Findings support the routine use of the CARD system to improve vaccine delivery and patient experience.