Pharmacists as providers: Targeting pneumococcal vaccinations to high risk populations
Pharmacists as providers: Targeting pneumococcal vaccinations to high risk populations
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DOI：
10.1016/j.vaccine.2011.08.051
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发表时间：
2011-10-19
期刊：
影响因子：
5.5
通讯作者：
Pegus, Cheryl
中科院分区：
文献类型：
--
作者：
Taitel, Michael;Cohen, Ed;Pegus, Cheryl
背景：老年人和慢性病患者患肺炎球菌病的风险增加。严重的肺炎球菌疾病给社会带来了巨大的人文和经济负担。虽然肺炎球菌疫苗接种（PPSV）可以降低严重后果的风险，但疫苗接种率并不理想。随着越来越多的人寻求每年在社区药店接种流感疫苗，药剂师有能力识别高危患者并提供PPSV。目的：本研究的目的是评估药剂师教育高危患者接受肺炎球菌疫苗接种的重要性的影响。方法：使用来自一家大型全国性连锁药店的去身份化声明，所有在8月1日之间接受过流感疫苗接种的患者，2010年和2010年11月14日，确定了符合PPSV的患者进行分析。根据免疫实践咨询委员会的建议，高危患者被确定为65岁以上或2-64岁的合并症患者。商业和医疗保险健康计划成员的基准医疗和药房索赔数据库被用来获得典型的传统护理提供的PPSV疫苗接种率，以比较基于药房的疫苗接种。期间发病率的PPSV计算和compared.Results：在130万的高危患者谁是在研究期间由药剂师接种疫苗，65,598（4.88%）也收到了肺炎球菌疫苗。这一疫苗接种率明显高于代表传统保健的2.90%的基准接种率（34，917/1，204，104; p < .001）。年龄在60-70岁的患者有最高的疫苗接种率（6.60%; 26,430/400,454）的任何年龄组。结论：药剂师是成功的，在识别高危患者，并提供额外的免疫服务。由药剂师同时接种PPSV和流感疫苗有可能提高PPSV的覆盖率。这些结果支持社区药剂师在提供健康和预防服务方面的作用不断扩大。(C)2011爱思唯尔有限公司版权所有。
Background: Older adults and persons with chronic conditions are at increased risk for pneumococcal disease. Severe pneumococcal disease represents a substantial humanistic and economic burden to society. Although pneumococcal vaccination (PPSV) can decrease risk for serious consequences, vaccination rates are suboptimal. As more people seek annual influenza vaccinations at community pharmacies, pharmacists have the ability to identify at-risk patients and provide PPSV.Objectives: The objective of this study was to evaluate the impact of pharmacists educating at-risk patients on the importance of receiving a pneumococcal vaccination.Methods: Using de-identified claims from a large, national pharmacy chain, all patients who had received an influenza vaccination between August 1, 2010 and November 14, 2010 and who were eligible for PPSV were identified for the analysis. Based on the Advisory Committee on Immunization Practices recommendations, at-risk patients were identified as over 65 years of age or as aged 2-64 with a comorbid conditions. A benchmark medical and pharmacy claims database of commercial and Medicare health plan members was used to derive a PPSV vaccination rate typical of traditional care delivery to compare to pharmacy-based vaccination. Period incidence of PPSV was calculated and compared.Results: Among the 1.3 million at-risk patients who were vaccinated by a pharmacist during the study period, 65,598 (4.88%) also received a pneumococcal vaccine. This vaccination rate was significantly higher than the benchmark rate of 2.90% (34,917/1,204,104; p < .001) representing traditional care. Patients aged 60-70 years had the highest vaccination rate (6.60%; 26,430/400,454) of any age group.Conclusions: Pharmacists were successful at identifying at-risk patients and providing additional immunization services. Concurrent immunization of PPSV with influenza vaccination by pharmacists has potential to improve PPSV coverage. These results support the expanding role of community pharmacists in the provision of wellness and prevention services. (C) 2011 Elsevier Ltd. All rights reserved.