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A hospital-based pharmacy intervention program for pneumococcal vaccination
T G Vondracek1, T P Pham, M M Huycke
1Department of Pharmacy Practice, University of Oklahoma Health Sciences Center, Oklahoma City, USA.
Insights
Hospital pharmacy programs using chart reminders significantly boosted pneumococcal vaccination rates in eligible inpatients. This simple intervention increased vaccinations by 10-fold in some services, helping meet national immunization goals.
Area of Science:
- Infectious Disease
- Hospital Pharmacy
- Public Health
Background:
- Pneumococcal vaccination rates in the US are below national targets.
- Invasive pneumococcal disease remains a significant public health concern, particularly among hospitalized patients.
- Effective strategies are needed to improve vaccine uptake in at-risk populations.
Purpose of the Study:
- To evaluate the impact of a hospital pharmacy-based intervention on pneumococcal vaccination rates.
- To determine if simple chart reminders could increase vaccine administration among eligible inpatients.
- To assess the feasibility of integrating vaccination reminders into routine hospital workflows.
Main Methods:
- A prospective study was conducted in an academic medical center.
- Inpatient records were reviewed daily to identify patients eligible for pneumococcal vaccine.
- A chart reminder system was implemented for eligible, unvaccinated patients.
Main Results:
- Of 447 inpatients, 224 (50.1%) were eligible for pneumococcal vaccine; only 64 (28.6%) had been previously vaccinated.
- During the intervention, 28.8% of eligible inpatients received the vaccine after chart reminders, compared to 0% in the observational period (P<.001).
- Vaccination rates were 10-fold higher on general medicine services than cardiology services during the intervention.
Conclusions:
- A hospital pharmacy program utilizing chart reminders is an effective strategy to increase pneumococcal vaccination rates.
- Simple interventions can significantly improve vaccine uptake in hospitalized patients at risk for invasive pneumococcal disease.
- This approach demonstrates the potential for hospital pharmacies to play a key role in public health immunization efforts.
Background:
Current pneumococcal vaccination rates are well below national goals.
Objective:
To determine whether pneumococcal vaccination rates could be increased with a hospital pharmacy-based program using simple chart reminders.
Methods:
On a daily basis, inpatient records on general medicine and cardiology services at an academic medical center were reviewed to determine which patients were eligible to receive pneumococcal vaccine. Eligible inpatients were interviewed, and the percentage of nonvaccinated inpatients given vaccine during hospitalization was determined. During an intervention period, reminders were placed on charts after the interview requesting a vaccine when indicated.
Results:
Of 447 inpatients, 224 (50.1%) had 1 or more indications for receiving pneumococcal vaccine. Only 64 (28.6%) had been previously vaccinated. One hundred fifty-eight (70.5%) of 224 vaccine-eligible patients had a prior hospitalization within the previous 5 years. Previous hospitalization was not significantly associated with having (48 [30.4%] of 158) or not having (16 [24.2%] of 66; P=.35) been vaccinated prior to admission. During the observational period, 0 of 80 vaccine-eligible, nonvaccinated inpatients were vaccinated before discharge. In comparison, 23 (28.8%) of 80 inpatients were vaccinated after a chart reminder (P<.001). During the intervention period, vaccination rates were 10-fold higher on general medicine services than on cardiology services.
Conclusions:
A hospital-based pharmacy vaccination program that relied on simple chart reminders was significantly associated with increased vaccination rates among inpatients at risk for invasive pneumococcal disease.