title: Improving herpes zoster vaccination rates through use of a clinical pharmacist and a personal health record.
abstract: BACKGROUND
  Preventative health services, including herpes zoster vaccination rates, remain low despite known benefits. A new care model to improve preventative health services is warranted. The objective of this study is to investigate whether the functions of an electronic medical record, in combination with a pharmacist as part of the care team, can improve the herpes zoster vaccination rate.
  
  
  METHODS
  This study was a 6-month, randomized controlled trial at a General Internal Medicine clinic at The Ohio State University. The 2589 patients aged 60 years and older without documented herpes zoster vaccination in the electronic medical record were stratified on the basis of activated personal health record status, an online tool used to share health information between patient and provider. Of the 674 personal health record users, 250 were randomized to receive information regarding the herpes zoster vaccination via an electronic message and 424 were randomized to standard of care. Likewise, of the 1915 nonpersonal health record users, 250 were randomized to receive the same information via the US Postal Service and 1665 were randomized to standard of care. After pharmacist chart review, eligible patients were mailed a herpes zoster vaccine prescription. Herpes zoster vaccination rates were compared by chi-square tests.
  
  
  RESULTS
  Intervention recipients had significantly higher vaccination rates than controls in both personal health record (relative risk, 2.7; P = .0007) and nonpersonal health record (relative risk, 2.9; P = .0001) patient populations.
  
  
  CONCLUSIONS
  Communication outside of face-to-face office visits, by both personal health record electronic message and information by mail, can improve preventative health intervention rates compared with standard care.
authors.affiliation: College of Pharmacy, The Ohio State University, Columbus, OH 43210, USA.
authors.forename: Shelley H
authors.initials: SH
authors.lastname: Otsuka
authors.forename: Neeraj H
authors.initials: NH
authors.lastname: Tayal
authors.forename: Kyle
authors.initials: K
authors.lastname: Porter
authors.forename: Peter J
authors.initials: PJ
authors.lastname: Embi
authors.forename: Stuart J
authors.initials: SJ
authors.lastname: Beatty
mesh_terms: D000368:Aged; D016009:Chi-Square Distribution; D005260:Female; D055991:Health Records, Personal; D053061:Herpes Zoster Vaccine / Q000008:administration & dosage*; D006801:Humans; D020407:Internet; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D009820:Ohio; D010342:Patient Acceptance of Health Care; D010353:Patient Education as Topic; D010595:Pharmacists; D011177:Postal Service
chemical_list: D053061:Herpes Zoster Vaccine
keywords: Electronic medical record; Electronic patient portal; Herpes zoster vaccine; Immunizations; Personal health record; Pharmacist; Primary care