多组分免疫干预对肺炎球菌和带状疱疹疫苗接种的影响：2 个州社区药房的随机对照试验。
Impact of a multi-component immunization intervention on pneumococcal and herpes zoster vaccinations: A randomized controlled trial of community pharmacies in 2 states.
机构信息
Auburn University Harrison School of Pharmacy, Department of Health Outcomes Research and Policy, 020 James E. Foy Hall, Auburn, AL, 36849, USA.
Keck Graduate Institute School of Pharmacy, 535 Watson Drive, Claremont, CA, 91711, USA.
出版信息
Res Social Adm Pharm. 2019 Dec;15(12):1453-1463. doi: 10.1016/j.sapharm.2019.01.006. Epub 2019 Feb 7.
BACKGROUND
The purpose of this study was to assess the impact of the We Immunize Program on structures, processes, and outcomes of pneumococcal and herpes zoster pharmacy-based immunization services.
METHODS
Pharmacy-technician pairs from 62 Alabama and California community pharmacies participated in a 6-month randomized controlled trial (intervention = 30/control = 32). All received immunization update training; intervention participants also received practical strategies training and monthly telephonic expert feedback. Completion of immunization service structure and process activities were analyzed using Fisher's Exact and one-way Mann-Whitney U tests. The primary outcome, change in number of pneumococcal, herpes zoster, and total vaccine doses administered, was assessed using one-way Wilcoxon signed rank and Mann-Whitney U tests. Associations between program and vaccine doses across time were explored using generalized estimating equations (GEE).
RESULTS
Intervention pharmacies completed more structure (median 12.00 versus 9.00, p = 0.200) and process activities (median 8.00 versus 7.00, p = 0.048) compared to control. Statistically significant increases in the median number of pneumococcal vaccine doses (7.50-12.00 doses, p = 0.007), and total vaccine doses (12.50-28.00 doses, p = 0.014) were seen from baseline to post-intervention within the intervention group. However, these changes were not statistically significant when compared to the control group (pneumococcal p = 0.136, total p = 0.202). Changes in median herpes zoster vaccine doses did not reach significance among intervention (8.50-9.00, p = 0.307) or control (9.00-13.00, p = 0.127) pharmacies.
CONCLUSIONS
Practical strategies training combined with tailored expert feedback enhanced existing pneumococcal immunization services in community pharmacies.
CLINICAL TRIAL REGISTRATION
ClinicalTrials.gov identifier: NCT02615470.
背景
本研究旨在评估 We Immunize 计划对肺炎球菌和带状疱疹药房免疫服务的结构、过程和结果的影响。
方法
来自阿拉巴马州和加利福尼亚州 62 家社区药房的药剂师对参与了一项为期 6 个月的随机对照试验（干预组=30/对照组=32）。所有参与者都接受了免疫更新培训；干预组还接受了实用策略培训和每月电话专家反馈。使用 Fisher's Exact 和单向曼-惠特尼 U 检验分析免疫服务结构和过程活动的完成情况。使用单向 Wilcoxon 符号秩和 Mann-Whitney U 检验评估主要结局（肺炎球菌、带状疱疹和总疫苗剂量的变化）。使用广义估计方程（GEE）探索方案与疫苗剂量随时间的关联。
结果
与对照组相比，干预组完成了更多的结构（中位数 12.00 与 9.00，p=0.200）和过程活动（中位数 8.00 与 7.00，p=0.048）。干预组从基线到干预后，肺炎球菌疫苗剂量（中位数 7.50-12.00 剂量，p=0.007）和总疫苗剂量（中位数 12.50-28.00 剂量，p=0.014）的中位数均显著增加。然而，与对照组相比，这些变化没有统计学意义（肺炎球菌 p=0.136，总 p=0.202）。干预组（中位数 8.50-9.00，p=0.307）和对照组（中位数 9.00-13.00，p=0.127）的带状疱疹疫苗剂量中位数变化均无统计学意义。
结论
实用策略培训结合定制的专家反馈增强了社区药房中现有的肺炎球菌免疫服务。
临床试验注册
ClinicalTrials.gov 标识符：NCT02615470。
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