Pneumococcal vaccination in hospitalized elderly patients: role of the pharmacist.

Abstract

To identify factors associated with receiving the pneumococcal vaccine before admission among hospitalized elderly patients and to determine patient perceptions about the role of the pharmacist in advocating its use. One hundred sixty elderly (> or = 65 yrs) patients hospitalized during the first 4 days of each month over a 5-month period were interviewed in person to obtain data regarding their attitudes toward receiving the vaccine, knowledge about it, access to health care, health status, and interaction with a pharmacist. Half of the patients had received the pneumococcal vaccine before hospital admission. Patient awareness of the vaccine and physician recommendation significantly predicted vaccination; health status and access to care did not. Provider communication to patients regarding the benefit of the vaccine was a significant factor leading to awareness about the vaccine, thereby resulting in a higher likelihood of vaccination. Half of the nonvaccinated patients were willing to receive the vaccine according to the pharmacist's recommendation. Although many patients preferred to receive the vaccine at their physician's office, nearly 40% had no preference or even preferred the pharmacy. However, only half of the patients had interacted with a pharmacist in the past, and only 20% were aware that some pharmacists are certified to administer the vaccine. Pneumococcal vaccine coverage is low among hospitalized elderly patients despite the presence of many comorbid conditions that place them at risk and are indications for the vaccine. The pharmacist as a provider can help increase vaccination coverage by recommending and offering the vaccine. Improvements in the level of pharmacist-patient interaction and promoting patient care services to the public are needed.