Skogg Annika, Zagel Alicia L, May O'Donnell R, Philbrick Ann M, Nelson Mary R, Schlichte Allyson, Klasen Kassie A
Fairview Pharmacy Services, 711 Kasota Ave SE, Minneapolis, MN 55414.
M Health Fairview Bethesda Clinic, 580 Rice St, St Paul, MN 55103.
Innov Pharm. 2024 Dec 12;15(4). doi: 10.24926/iip.v15i4.6345. eCollection 2024.
Pneumococcal vaccination rates among eligible adults are lower than desired. Recently, pneumococcal vaccination guidelines for adults were updated to include new pneumococcal conjugate vaccines (PCV20), taking into consideration age, underlying risk factors, and previous vaccine status. To respond to PCV under-vaccination and help clarify the new guidelines, this project sought to develop a targeted pneumococcal vaccine screening tool and pop-up alert within retail pharmacies across a large health system with the goal of increasing rates of PCV20 vaccination. A Plan-Do-Study-Act (PDSA) cycle was employed to activate alerts within 24 retail pharmacies for patients indicated to be eligible for PCV20 vaccination. Adult patients who were PCV20 vaccine-naïve, met eligibility requirements, and were due for medication refill were identified through the electronic health record and uploaded to pharmacy software. Pharmacists screened patients for eligibility and inquired about willingness to receive PCV20 vaccine during the upcoming pharmacy visit. Vaccine rates and sociodemographic characteristics were compared before and after the PDSA cycle began, and reasons for patient decline were assessed. Between December 2023 and April 2024, 1821 patients were screened for PCV20 vaccines, with 1369 (75%) patients eligible. Ultimately, 130 patients (9%) received PCV20 through the alert process, yet an additional 285 PCV20 vaccines were administered to additional patients, perhaps due to the intervention's success in promoting the tools such that pharmacists were more comfortable in screening patients for PCV20 vaccinations overall. Overall, the study represented a 140% increase in PCV20 vaccination rates compared to the same period of the previous year. The most common reason for declining vaccination was no interest in vaccines (n=231, 51%). This PDSA cycle demonstrated a vast increase in PCV20 vaccination rates in retail pharmacies across a large health system, indicating the potential utility of integrated technologic screening tools and alerts to increase administration of other routine immunizations.
符合条件的成年人肺炎球菌疫苗接种率低于预期。最近，成人肺炎球菌疫苗接种指南进行了更新，纳入了新的肺炎球菌结合疫苗（PCV20），同时考虑了年龄、潜在风险因素和既往疫苗接种情况。为应对PCV疫苗接种不足的问题并帮助阐明新指南，本项目旨在开发一种有针对性的肺炎球菌疫苗筛查工具，并在一个大型医疗系统的零售药店内设置弹出式提醒，目标是提高PCV20疫苗的接种率。采用计划-执行-研究-行动（PDSA）循环在24家零售药店内为符合PCV20疫苗接种条件的患者激活提醒。通过电子健康记录识别出未接种过PCV20疫苗、符合资格要求且即将进行药物 refill的成年患者，并上传至药房软件。药剂师对患者的资格进行筛查，并询问他们在即将到来的药房就诊期间是否愿意接种PCV20疫苗。比较了PDSA循环开始前后的疫苗接种率和社会人口学特征，并评估了患者拒绝接种的原因。在2023年12月至2024年4月期间，对1821名患者进行了PCV20疫苗筛查，其中1369名（75%）患者符合条件。最终，有130名患者（9%）通过提醒流程接种了PCV20，但另外还有285名患者接种了PCV20疫苗，这可能是由于该干预措施成功推广了相关工具，使得药剂师在总体上对为患者进行PCV20疫苗接种筛查时更加得心应手。总体而言，与上一年同期相比，该研究表明PCV20疫苗接种率提高了140%。拒绝接种疫苗的最常见原因是对疫苗不感兴趣（n = 231，51%）。这个PDSA循环表明，一个大型医疗系统的零售药店中PCV20疫苗接种率大幅提高，这表明集成技术筛查工具和提醒对于增加其他常规免疫接种的实施具有潜在效用。
