Impact of a Vaccine Screening Program for Persons with Diabetes in an Independent Community Pharmacy
Author: Thompson BT, Chapman AR, Huie CH, Rhodes LA, Marciniak MW
Practice Site: UNC Eshelman School of Pharmacy; Brame Huie Pharmacy - North Wilkesboro, NC
Background: The American Diabetes Association and the Centers for Disease Control and Prevention recommend persons with diabetes receive influenza, pneumococcal polysaccharide, and hepatitis B vaccines. Adult immunizations rates remain lower than the Healthy People 2020 vaccination goals. Community pharmacists are well-positioned as accessible providers who can identify patients with diabetes at risk for vaccine-preventable diseases.
Objective: The primary objective of this study is to evaluate the impact of vaccine screening on improving immunization rates in patient with diabetes.
Methods: This prospective interventional study was conducted in an independent community pharmacy in North Carolina from January 10, 2017 to March 10, 2017. Pharmacy staff were trained on study procedures and investigator-developed tools prior to study launch. Inclusion criteria were age ≥ 18 years, receiving prescriptions or clinical services at the pharmacy, and receipt of a chronic diabetes medication. Individuals < 18 years of age were excluded. A pharmacist entered pertinent data into an investigator developed Follow-up Log as intervention eligible patients were identified. A Bag Tag was attached to the prescription bag to alert the patient that the pharmacist would like to discuss a potential vaccination opportunity. When the patient picked up the prescription, a pharmacist completed a Vaccine Eligibility Tool and recommend needed vaccines to the patient. If the patient accepted the recommendation, the vaccine was administered by the pharmacist. Data collected included: age, gender, insurance provider, results of screening (eligible or ineligible), vaccines administered, and reason for declination of recommendation (if appropriate). Descriptive statistics were used to analyze study results. Immunization rates from the study time frame were compared to immunization rates in persons with diabetes from January 10, 2016 to March 10, 2016 when the vaccine screening program was not in effect.
Preliminary Results: Study participants had a mean age of 63 years, 51.5% (n=53) male, 58.3% (n=60) had Medicare insurance and approximately 30.1% (n=31) had private insurance. A total of 104 screenings were performed during the study timeframe. Of all eligible patients screened, approximately 81.7% (n=84) were eligible for influenza, pneumococcal polysaccharide, and hepatitis B vaccination. Vaccines administered from January 10, 2017 to March 20, 2017 included: influenza (n=4), pneumococcal polysaccharide (n=4), and hepatitis B (n=0). Vaccines administered from January 10, 2016 to March 10, 2017 included: influenza (n=2), pneumococcal polysaccharide (n=0), and hepatitis B (n=0).
Conclusion: Implementation of a community pharmacist-led vaccine screening program identified patients eligible for vaccination. A pharmacist-led vaccine screening program resulted in a four-fold increase in the number of immunizations administered in an independent community pharmacy setting.