J Am Pharm Assoc (2003). 2019 Jan-Feb;59(1):30-34. doi: 10.1016/j.japh.2018.09.007. Epub 2018 Nov 6.
To compare the completeness of immunization records for 6 vaccines between a community pharmacy database, a regional immunization information system (IIS), and a health system's electronic health record (EHR).
In a community pharmacy immunization program, 2 pharmacists and a community pharmacy resident performed a needs assessment for 6 vaccines (tetanus-diphtheria-acellular pertussis vaccine for adults or diphtheria-tetanus-acellular pertussis vaccine for children and adolescents, zoster vaccine live, 13-valent pneumococcal conjugate vaccine, 23-valent pneumococcal polysaccharide vaccine, hepatitis B vaccine series, and human papillomavirus vaccine) for more than 2400 patients from August 2016 to March 2017. This was a retrospective study to review immunization records for 243 patients. Inclusion criteria included patients from the community pharmacy immunization program who also had at least 1 medication prescribed by an academic health system provider. Immunization records for 6 vaccines were collected from the community pharmacy database, the regional IIS, and the EHR.
A total of 186 of 243 patients (77%) had additional immunization records in the regional IIS or EHR that were not found in the community pharmacy database. Among those 186 patients, 108 (58%) had additional immunization records for 2 or more unique vaccines. In total, 378 additional immunization records were identified for the 6 vaccines. For all 6 vaccines, the regional IIS and EHR possessed more complete immunization records than the community pharmacy database (P < 0.05 for HPV and P < 0.001 for the remaining 5 vaccines).
Our study showed that immunization records were more complete in a regional IIS and health system EHR compared with a community pharmacy database. If all 3 sources were used by the pharmacist during the needs assessment, the community pharmacy team would have made fewer vaccine recommendations, which would have reduced the potential for duplicate or inappropriate vaccines.
比较社区药房数据库、区域免疫信息系统（IIS）和医疗系统电子健康记录（EHR）中 6 种疫苗免疫记录的完整性。
在社区药房免疫计划中，2 名药剂师和 1 名社区药房住院医师对 2400 多名患者（成人使用破伤风-白喉-无细胞百日咳疫苗或儿童和青少年使用白喉-破伤风-无细胞百日咳疫苗、带状疱疹活疫苗、13 价肺炎球菌结合疫苗、23 价肺炎球菌多糖疫苗、乙型肝炎疫苗系列和人乳头瘤病毒疫苗）进行了 6 种疫苗（破伤风-白喉-无细胞百日咳疫苗或白喉-破伤风-无细胞百日咳疫苗、带状疱疹活疫苗、13 价肺炎球菌结合疫苗、23 价肺炎球菌多糖疫苗、乙型肝炎疫苗系列和人乳头瘤病毒疫苗）的需求评估。这是一项回顾性研究，共对 243 名患者的免疫记录进行了审查。纳入标准包括来自社区药房免疫计划且至少有 1 种由学术医疗系统提供者开具的药物的患者。从社区药房数据库、区域 IIS 和 EHR 收集了 6 种疫苗的免疫记录。
在社区药房数据库中未发现的情况下，共有 243 名患者中的 186 名（77%）在区域 IIS 或 EHR 中还有其他免疫记录。在这 186 名患者中，有 108 名（58%）有 2 种或以上不同疫苗的额外免疫记录。共确定了 378 例 6 种疫苗的额外免疫记录。对于所有 6 种疫苗，区域 IIS 和 EHR 比社区药房数据库具有更完整的免疫记录（HPV 的 P < 0.05，其余 5 种疫苗的 P < 0.001）。
我们的研究表明，与社区药房数据库相比，区域 IIS 和医疗系统 EHR 中的免疫记录更完整。如果药剂师在需求评估期间使用了这 3 个来源，社区药房团队的疫苗推荐就会更少，从而减少重复或不适当疫苗的潜在风险。
