title: Pharmacists as providers: targeting pneumococcal vaccinations to high risk populations.
abstract: BACKGROUND
  Older adults and persons with chronic conditions are at increased risk for pneumococcal disease. Severe pneumococcal disease represents a substantial humanistic and economic burden to society. Although pneumococcal vaccination (PPSV) can decrease risk for serious consequences, vaccination rates are suboptimal. As more people seek annual influenza vaccinations at community pharmacies, pharmacists have the ability to identify at-risk patients and provide PPSV.
  
  
  OBJECTIVE
  The objective of this study was to evaluate the impact of pharmacists educating at-risk patients on the importance of receiving a pneumococcal vaccination.
  
  
  METHODS
  Using de-identified claims from a large, national pharmacy chain, all patients who had received an influenza vaccination between August 1, 2010 and November 14, 2010 and who were eligible for PPSV were identified for the analysis. Based on the Advisory Committee on Immunization Practices recommendations, at-risk patients were identified as over 65 years of age or as aged 2-64 with a comorbid conditions. A benchmark medical and pharmacy claims database of commercial and Medicare health plan members was used to derive a PPSV vaccination rate typical of traditional care delivery to compare to pharmacy-based vaccination. Period incidence of PPSV was calculated and compared.
  
  
  RESULTS
  Among the 1.3 million at-risk patients who were vaccinated by a pharmacist during the study period, 65,598 (4.88%) also received a pneumococcal vaccine. This vaccination rate was significantly higher than the benchmark rate of 2.90% (34,917/1,204,104; p<.001) representing traditional care. Patients aged 60-70 years had the highest vaccination rate (6.60%; 26,430/400,454) of any age group.
  
  
  CONCLUSIONS
  Pharmacists were successful at identifying at-risk patients and providing additional immunization services. Concurrent immunization of PPSV with influenza vaccination by pharmacists has potential to improve PPSV coverage. These results support the expanding role of community pharmacists in the provision of wellness and prevention services.
authors.affiliation: Clinical Outcomes & Analytic Services, Walgreens Co., 1415 Lake Cook Road, MS #L444, Deerfield, IL 60015, USA. michael.taitel@walgreens.com
authors.forename: Michael
authors.initials: M
authors.lastname: Taitel
authors.forename: Ed
authors.initials: E
authors.lastname: Cohen
authors.forename: Ian
authors.initials: I
authors.lastname: Duncan
authors.forename: Cheryl
authors.initials: C
authors.lastname: Pegus
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002648:Child; D002675:Child, Preschool; D005260:Female; D006801:Humans; D017589:Immunization Programs / Q000379:methods; D007223:Infant; D007231:Infant, Newborn; D007252:Influenza Vaccines / Q000008:administration & dosage; D008297:Male; D008875:Middle Aged; D010595:Pharmacists; D011008:Pneumococcal Infections / Q000517:prevention & control*; D022242:Pneumococcal Vaccines / Q000008:administration & dosage*; D044382:Population Groups; D012308:Risk Management / Q000379:methods*; D014611:Vaccination / Q000379:methods*; D055815:Young Adult
chemical_list: D007252:Influenza Vaccines; D022242:Pneumococcal Vaccines