Simple intervention ups pneumococcal vaccination rate

Sonali P. Desai, M.D., M.P.H., of the Brigham and Women's Hospital in Boston, and colleagues evaluated the effects of a quality improvement strategy involving a paper point-of-care reminder form designed to increase the percentage of immunosuppressed patients who kept up-to-date with pneumococcal vaccination, in a rheumatology practice. The cohort included 3,717 patients who were taking immunosuppressive medications (66.0 percent with rheumatoid arthritis; 74.1 percent women).

The researchers found that, in the time period following the intervention, there was a significant increase in the rate of patients who were up-to-date with pneumococcal vaccination for rheumatologists in the intervention (67.6 to 80.0 percent), compared with a stable rate among rheumatologists in the nonintervention control (52.3 to 52.0 percent). Positive predictors of receiving the appropriate vaccinations including having received the intervention (hazard ratio [HR], 3.58), having a primary care physician affiliated with Brigham and Women's Hospital (HR, 1.68), having a diagnosis of diabetes mellitus (HR, 1.57), and being 56 to 65 years of age at baseline (HR, 1.24).

"It is possible to significantly increase vaccination for an important at-risk immunosuppressed patient population through the use of a simple point-of-care reminder," the authors write. "Future efforts should continue to study and test quality improvement methods in order to effect sustained change."

One author disclosed financial ties to the pharmaceutical industry and UpToDate.

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Journal reference: Arthritis & Rheumatism

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