Coley Kim C, Gessler Chiara, McGivney Melissa, Richardson Renee, DeJames John, Berenbrok Lucas A
University of Pittsburgh, School of Pharmacy, 5607 Baum Boulevard, Room 303, Pittsburgh, PA 15206, USA.
Giant Eagle, Inc., 101 Kappa Drive, Pittsburgh, PA 15238, USA.
Vaccine. 2020 May 19;38(24):4044-4049. doi: 10.1016/j.vaccine.2020.02.040. Epub 2020 Feb 21.
Millions of American adults do not receive the recommended vaccinations each year. Community pharmacies are well positioned to help fill this gap through easy access and innovative patient-centered interventions. The primary goal of this demonstration project was to implement new notification and motivational interviewing processes at a regional supermarket chain pharmacy to increase the number of influenza, pertussis, pneumococcal, and herpes zoster vaccines provided to adults.
This prospective, observational project utilized a pre-post design. Algorithms were developed with pharmacy dispensing data to identify vaccine-eligible patients. Pharmacy staff then received automated notifications through one of the following: (1) a vaccine message printed on the prescription receipt or on paper attached to the prescription bag when patients came to the pharmacy; or (2) a patient list generated through commercially-available software listing patient contact information and which vaccine they were eligible to receive. Irrespective of the notification process, pharmacy staff employed motivational interviewing techniques either face-to-face or telephonic to engage patients in conversation about getting vaccinated. Finally, an interface to the statewide vaccination registry was developed and tested to transmit vaccination information from all pharmacy locations.
Ninety-nine pharmacies participated in the demonstration project across western Pennsylvania. A 33% increase in vaccinations was recorded over the prior year. Increases in vaccines were demonstrated in three of the four vaccine types: 45% for influenza, 31% for pertussis, and 7% for pneumococcal vaccinations. A decrease of 5% was observed for herpes zoster vaccinations. A successful connection to the statewide vaccine registry was established and 100% of all vaccines administered were transmitted to the registry.
A combination of face-to-face and telephonic interventions with motivational interviewing were successful at increasing adult vaccinations in a regional supermarket chain pharmacy. Equal and sustained prioritization for all vaccines is necessary to achieve increases across all vaccine types.
每年有数百万美国成年人未接种推荐的疫苗。社区药房凭借便捷的服务和以患者为中心的创新干预措施，有能力填补这一空白。本示范项目的主要目标是在一家区域连锁超市药房实施新的通知和动机性访谈流程，以增加向成年人提供的流感、百日咳、肺炎球菌和带状疱疹疫苗的接种数量。
本前瞻性观察项目采用前后对照设计。利用药房配药数据开发算法，以识别符合接种疫苗条件的患者。药房工作人员随后通过以下方式之一收到自动通知：（1）当患者到药房时，在处方收据上或附在药袋上的纸上打印疫苗信息；或（2）通过商业软件生成的患者名单，列出患者联系信息以及他们符合接种的疫苗。无论采用何种通知流程，药房工作人员都采用面对面或电话方式的动机性访谈技巧，与患者就接种疫苗进行沟通。最后，开发并测试了与全州疫苗接种登记系统的接口，以传输所有药房地点的疫苗接种信息。
宾夕法尼亚州西部的99家药房参与了该示范项目。与上一年相比，接种量增加了33%。四种疫苗类型中的三种显示出接种量增加：流感疫苗增加45%，百日咳疫苗增加31%，肺炎球菌疫苗增加7%。带状疱疹疫苗接种量下降了5%。成功建立了与全州疫苗登记系统的连接，所有接种的疫苗中有100%传输到了登记系统。
在一家区域连锁超市药房，将面对面和电话干预与动机性访谈相结合，成功增加了成人疫苗接种量。要实现所有疫苗类型的接种量增加，对所有疫苗给予同等且持续的重视是必要的。
