Abstract
ObjectivesTo describe our statewide, pharmacist-led education campaign to increase knowledge and awareness of pneumococcal immunization recommendations. SettingImmunization providers and residents in the state of Rhode Island. Practice descriptionA clinical pathway (i.e., decision-support tool) was developed to educate health professionals about appropriate indications, administration schedules, and frequently asked questions for the 2 different adult pneumococcal vaccines. Academic detailing and distribution of the clinical pathway to health professionals was conducted across Rhode Island. Community outreach activities included radio ads as well as distribution of patient handouts and wallet cards at community events. Practice innovationTo our knowledge, this was the first statewide, pharmacist-driven academic detailing and community outreach campaign to promote adult pneumococcal vaccination. EvaluationAcademically detailed immunization providers received a 6-question survey. Pneumococcal disease rate differences between the study periods were evaluated with the use of Fisher exact tests, whereas changes in vaccination were assessed with the use of chi-square tests. ResultsFrom November 2013 through July 2015, our academic detailers visited and distributed our vaccination pathway materials to more than 400 practice sites across Rhode Island, including 68% of community pharmacies and all adult acute care hospitals. Of the 413 surveys completed, 92% of respondents agreed that their knowledge of the pneumococcal conjugate vaccine, 13-valent and pneumococcal polysaccharide vaccine, 23-valent had improved. Pneumococcal vaccination increased significantly (absolute difference 3.9%, percentage change in proportion 5.4%; P = 0.01), and pneumococcal disease decreased significantly between the preintervention and intervention periods (−2.74/10,000 discharges [95% CI −5.15 to −0.32], P = 0.02). Invasive pneumococcal disease decreased by 21 cases per 1,000,000 population per year between the preintervention and postintervention periods (−42.25 to 0.14, P = 0.05). ConclusionOur statewide, pharmacist-driven pneumococcal vaccination educational outreach program resulted in favorable provider feedback relative to knowledge change and perceptions. Vaccination increased and pneumococcal disease decreased during the study period.
Highlights
More than half of pneumococcal disease in older adults occurs in non-vaccinated patients who have an indication for pneumococcal vaccination.[1,2] an estimated 67 million at-risk individuals in the United States (US) have not yet been vaccinated.[1,2] This data is extremely concerning because patients with Advisory Committee on Immunization Practices (ACIP) indications for pneumococcal vaccination are twice as likely to die as those without indications if they develop invasive pneumococcal disease.[3]
To assess the effectiveness of our approach for improving pneumococcal vaccination in Rhode Island through education, we evaluated a range of outcomes, including changes in vaccination rates, invasive pneumococcal infections, and pneumococcal pneumonia, as well as provider feedback on academic detailing
Academic detailing Academic detailing was assessed with surveys of licensed immunization providers
Summary
More than half of pneumococcal disease in older adults occurs in non-vaccinated patients who have an indication for pneumococcal vaccination.[1,2] an estimated 67 million at-risk individuals in the United States (US) have not yet been vaccinated.[1,2] This data is extremely concerning because patients with Advisory Committee on Immunization Practices (ACIP) indications for pneumococcal vaccination are twice as likely to die as those without indications if they develop invasive pneumococcal disease.[3] Despite this grave reality, and efforts to improve national pneumococcal vaccination rates among populations that should be vaccinated, vaccinations rates rarely reach 75%.4-6. Pneumococcal vaccination in adults aged 65 years and older has remained relatively stable over the past several years, it is still well below the Healthy People 2020 goal of 90%.4. A significant challenge with adult vaccinations, as opposed to childhood vaccinations, is awareness of vaccination indications among immunization providers and patients.[7,8,9,10] This is problematic in adult populations since vaccine status assessment by healthcare providers is not routine, patients often receive care at multiple locations (indicating care may not be coordinated), and patients may be unaware of their immunization status.[7,8,9,10] Further, pneumococcal vaccination recommendations have undergone several changes in recent years and can be complex depending on the patient’s age, medical conditions, and previous pneumococcal vaccination status.[11,12,13,14,15]
Sign-in/Register to view highlights & summary Sign-in/Register to access full text options 
Free) 
Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a call
