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Thomas G. Vondracek, PharmD; Trinh P. Pham, PharmD; Mark M. Huycke, MD

Arch Intern Med. 1998;158:1543-1547.

Background  Current pneumococcal vaccination rates are well below national goals.

Objective  To determine whether pneumococcal vaccination rates could be increased with a hospital pharmacy-based program using simple chart reminders.

Methods  On a daily basis, inpatient records on general medicine and cardiology services at an academic medical center were reviewed to determine which patients were eligible to receive pneumococcal vaccine. Eligible inpatients were interviewed, and the percentage of nonvaccinated inpatients given vaccine during hospitalization was determined. During an intervention period, reminders were placed on charts after the interview requesting a vaccine when indicated.

Results  Of 447 inpatients, 224 (50.1%) had 1 or more indications for receiving pneumococcal vaccine. Only 64 (28.6%) had been previously vaccinated. One hundred fifty-eight (70.5%) of 224 vaccine-eligible patients 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 prior to admission. During the observational period, 0 of 80 vaccine-eligible, nonvaccinated inpatients were vaccinated before discharge. In comparison, 23 (28.8%) of 80 inpatients were vaccinated after a chart reminder (P<.001). During the intervention period, vaccination rates were 10-fold higher on general medicine services than on cardiology services.

Conclusions  A hospital-based pharmacy vaccination program that relied on simple chart reminders was significantly associated with increased vaccination rates among inpatients at risk for invasive pneumococcal disease.

From the Departments of Pharmacy Practice (Drs Vondracek and Pham) and Medicine (Dr Huycke), University of Oklahoma Health Sciences Center, and the Medical Service, Department of Veterans Affairs Medical Center (Dr Huycke), Oklahoma City, Okla.

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