Physician-Pharmacy Collaboration to Increase Patient Acceptance of Pneumococcal Immunization Prior to Inpatient Discharge

BACKGROUND

Pneumococcal disease, a significant cause of morbidity and mortality in at-risk adult populations, remains substantially under-vaccinated despite the availability of an effective vaccine and clear guidelines for its administration. Addressing this issue is of paramount importance to public health, and this study focuses on enhancing the rates of Pneumococcal vaccine acceptance through pharmacy-led patient education during hospital admissions.

Previous research suggests that hospital environments, outside of primary care, present an opportunity for vaccination, especially in the acute care setting and many previous studies have attempted different types of interventions for the influenza vaccines and previous pneumococcal vaccines. In these studies, improvements in vaccination rates were seen from interventions including dedicated clinics, standing orders, strong provider recommendations, reminder systems, and pharmacists screening and educating patients in collaboration with nursing. There is also evidence that collaborative efforts with pharmacy and nursing have shown significant increases in vaccination rates. The role of the pharmacy student was also evaluated in previous studies which showed a 20% increase in vaccination rates with little increase in resources used. While multiple strategies have been employed over the years to improve vaccine uptake, there's a significant hurdle to overcome in patient refusal. Pharmacist led interventions were shown to increase the rate of vaccination in the inpatient setting, however refusal rates remain high, showing the need for a more tailored approach. A review of the relationship between demographic factors and adult immunization rates showed that higher education and income levels correlated with increased vaccination rates and more informed attitudes, however, a deeper dive into the reason behind refusal in warranted to help overcome the hurdle. A notable factor that remains unknown is having a better understanding the patient's viewpoint towards vaccines. Keeping this in mind, this study will use a physician-pharmacy collaborative intervention as method to enhance vaccine acceptance rates, but more importantly, will collect information on the impact of the intervention through surveying the patient's viewpoint behind their decision.

This study will target adult patients admitted to the hospital who fall under the recommended criteria for the Pneumococcal vaccine, especially those aged 65 years or older and at-risk categories. The primary endpoint will be the rate of Pneumococcal vaccine acceptance among eligible patients' post-pharmacy intervention compared to standard care without the intervention.

It is anticipated that there will be an increase in the rates of Pneumococcal vaccine acceptance post-pharmacy intervention. The rationale behind this hypothesis is built upon the foundational understanding that personal interaction and education by a pharmacist can provide a level of clarity, confidence, and trust in patients. Potential pitfalls could include resistance from patients due to prior beliefs or misconceptions about vaccines, administrative challenges in implementing pharmacy-led interventions, or logistical issues in vaccine supply. The secondary endpoint of the study will be to uncover some of the reasons behind refusal of the vaccine by surveying all patients regarding the reason for their decision.