A HOSPITAL-BASED PHARMACY INTERVENTION PROGRAM FOR PNEUMOCOCCAL VACCINATION

Background: Current pneumococcal vaccination rates are well below nati onal goals. Objective: To determine whether pneumococcal vaccination r ates could be increased with a hospital pharmacy-based program using s imple chart reminders. Methods: On a daily basis, inpatient records on general medicine and cardiology services at an academic medical cente r were reviewed to determine which patients were eligible to receive p neumococcal vaccine. Eligible inpatients were interviewed, and the per centage of nonvaccinated inpatients given vaccine during hospitalizati on was determined. During an intervention period, reminders were place d on charts after the interview requesting a vaccine when indicated. R esults: Of 447 inpatients, 224 (50.1%) had 1 or more indications for r eceiving pneumococcal vaccine. Only 64 (28.6%) had been previously vac cinated. One hundred fifty-eight (70.5%) of 224 vaccine-eligible patie nts had a prior hospitalization within the previous 5 years. Previous hospitalization was not significantly associated with having (48 [30.4 %] of 158) or not having (16 [24.2%] of 66; P =.35) been vaccinated pr ior to admission. During the observational period, 0 of 80 vaccine-eli gible, nonvaccinated inpatients were vaccinated before discharge. In c omparison, 23 (28.8%) of 80 inpatients were vaccinated after a chart r eminder (P<.001). During the intervention period, vaccination rates we re 10-fold higher on general medicine services than on cardiology serv ices. Conclusions: A hospital-based pharmacy vaccination program that relied on simple chart reminders was significantly associated with inc reased vaccination rates among inpatients at risk for invasive pneumoc occal disease.