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Improving Herpes Zoster Vaccination Rates Through Use of a Clinical Pharmacist and a Personal Health Record - 20/08/13

Doi : 10.1016/j.amjmed.2013.02.018 
Shelley H. Otsuka, PharmD a, Neeraj H. Tayal, MD b, Kyle Porter, MAS c, Peter J. Embi, MD, MS b, d, Stuart J. Beatty, PharmD a,
a College of Pharmacy, The Ohio State University, Columbus 
b College of Medicine, Department of Internal Medicine, The Ohio State University College of Medicine, Columbus 
c Center for Biostatistics, The Ohio State University, Columbus 
d Division of Rheumatology and Immunology, The Ohio State University, Columbus 

Requests for reprints should be addressed to Stuart J. Beatty, PharmD, BCPS, College of Pharmacy, The Ohio State University, A218 Lloyd M. Parks Hall, 500 West 12th Ave, Columbus, OH 43210.

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.

El texto completo de este artículo está disponible en PDF.

Keywords : Electronic medical record, Electronic patient portal, Herpes zoster vaccine, Immunizations, Personal health record, Pharmacist, Primary care


Esquema


 Funding: None.
 Conflict of Interest: None.
 Authorship: All authors had access to the data and played a role in writing this manuscript.


© 2013  Elsevier Inc. Reservados todos los derechos.
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Vol 126 - N° 9

P. 832.e1-832.e6 - septembre 2013 Regresar al número
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