Improving Herpes Zoster Vaccination Rates Through Use of a Clinical Pharmacist and a Personal Health Record

Otsuka, Shelley; Tayal, Neeraj; Porter, Kyle; Embí, Peter J.; Beatty, Stuart J.

doi:10.1016/j.amjmed.2013.02.018

Cited by 39 publications

(32 citation statements)

References 13 publications

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“…29,54 Evidence suggests some success of pharmacy interventions to remove barriers to shingles vaccination and increase shingles vaccination coverage. 55–58 Because of Part D reimbursement structure, convenience of pharmacy locations and hours, and pharmacists' established roles as vaccination providers, pharmacists are in an optimal position to identify, educate, and vaccinate eligible patients against shingles. 29,54–58 Other comprehensive strategies for improving shingles vaccination uptake include use of reminder/recall systems; educational campaigns; use of standing orders; linking delivery of shingles vaccine to delivery of other indicated adult vaccines (e.g., influenza); and routinely assessing patients' vaccination status.…”

Section: Discussionmentioning

confidence: 99%

National and State-Specific Shingles Vaccination Among Adults Aged ≥60 Years

Williams

Harpaz

2017

American Journal of Preventive Medicine

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Introduction Shingles (herpes zoster) causes substantial morbidity, especially among older adults. The shingles vaccine has been recommended for people aged ≥60 years since 2006. This study assessed recent shingles vaccination at national and state levels among adults aged ≥60 years. Methods The 2014 Behavioral Risk Factor Surveillance System data were analyzed in 2015 to assess shingles vaccination coverage among adults aged ≥60 years at national and state levels. Multivariable logistic regression and predictive marginal models identified factors independently associated with vaccination. Results Shingles vaccination coverage among adults aged ≥60 years was 31.8% (95% CI=31.4%, 32.2%). Among states, shingles vaccination coverage ranged from 17.8% (95% CI=15.8%, 20.0%) in Mississippi to 46.6% (95% CI=44.3%, 48.8%) in Vermont, with a median of 33.3%. Coverage was <25% in four states and >40% in nine states. For all states, coverage was significantly higher among non-Hispanic whites compared with non-white races except for Oregon, with coverage differences ranging from −33.2% in the District of Columbia to 0.9% in Oregon and a median of −16.0%. Characteristics independently associated with vaccination were age, race/ethnicity, sex, education, employment status, household income, region, perceived health status, health insurance status, personal healthcare provider, routine checkup status, and whether reporting that cost was a barrier to seeing a doctor. Conclusions Coverage varied dramatically by state. State-level comparisons may aid in designing tailored intervention programs through sharing of best practices. Strategies are needed to mitigate financial barriers for both provider and patients, improve awareness, and increase provider recommendation of the vaccine.

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Section: Discussionmentioning

confidence: 99%

National and State-Specific Shingles Vaccination Among Adults Aged ≥60 Years

Williams

Harpaz

2017

American Journal of Preventive Medicine

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“…With the recent emphasis on comparative effectiveness research (CER) and precision medicine, studies are using or planning to use EHR to facilitate recruitment and consent and collect clinical data (Kaelber, Foster, Gilder, Lore, & Jain, 2012; Baer et al, 2013; Fleurence et al, 2014; Fleurence et al, 2014; Lu et al, 2014; Collins & Varmus, 2015). EHRs can provide an automated electronic approach to (1) identify or flag potential subjects at the point of clinical care (Ruffin & Nease, 2011; Brieger & Aliprandi-Costa, 2013; Amin et al, 2014; Smith et al, 2007); (2) differentiate between clinical and research procedures/costs; (3) extract clinical data for import into study databases (Waitman et al, 2014) (Hunkeler et al, 2012; Sargious & Lee, 2014); and (4) collect study clinical outcomes directly (Otsuka et al, 2013; Basch, 2014; Stillman et al, 2014). Health systems with comprehensive integrated EHRs, like the Department of Veterans Affairs (VA), are starting to use this approach to recruit, screen, randomize, obtain consent, and collect data.…”

Section: 0 Integrating E-technologies Into Clinical Trial Design Imentioning

confidence: 99%

Using e-technologies in clinical trials

Rosa

Campbell

Miele

et al. 2015

Contemporary Clinical Trials

135

111

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Clinical trials have been slow to incorporate e-technology (digital and electronic technology that utilizes mobile devices or the Internet) into the design and execution of studies. In the meantime, individuals and corporations are relying more on electronic platforms and most have incorporated such technology into their daily lives. This paper provides a general overview of the use of e-technologies in clinical trials research, specifically within the last decade, marked by rapid growth of mobile and Internet-based tools. Benefits of and challenges to the use of e-technologies in data collection, recruitment and retention, delivery of interventions, and dissemination are provided, as well as a description of the current status of regulatory oversight of e-technologies in clinical trials research. As an example of ways in which e-technologies can be used for intervention delivery, a summary of e-technologies for treatment of substance use disorders is presented. Using e-technologies to design and implement clinical trials has the potential to reach a wide audience, making trials more efficient while also reducing costs; however, researchers should be cautious when adopting these tools given the many challenges in using new technologies, as well as threats to participant privacy/confidentiality. Challenges of using e-technologies can be overcome with careful planning, useful partnerships, and forethought. The role of web- and smartphone-based applications is expanding, and the increasing use of those platforms by scientists and the public alike make them tools that cannot be ignored.

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“…Pharmacists also assist with health promotion programs, by increasing immunization rates or using EHRs and patient registries to identify those at risk for adverse drug reactions. 42,43 Though fewer formal evaluations have been done of population-based services, 44 given the broad impact of such services, they may be particularly cost effective for PCMHs.…”

Section: Quality and Safety Of Carementioning

confidence: 99%

The role of the pharmacist in patient-centered medical home practices: current perspectives

Lewis¹,

Shimp²,

Rockafellow³

et al. 2014

IPRP

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Patient-centered medical homes (PCMHs) are the centerpiece of primary care transformation in the US. They are intended to improve care coordination and communication, enhance health care quality and patient experiences, and lower health care costs by linking patients to a physician-led interdisciplinary health care team. PCMHs are widely supported by health care associations, payers, and employers. Health care accreditation organizations have created performance measures that promote the adoption of PCMH core attributes. Public and private payers are increasingly providing incentives and bonuses related to performance measure status. Evidence-based prescription, medication adherence, medication use coordination, and systems to support medication safety are all necessary components of PCMHs. Pharmacists have unique knowledge and skills that can complement the care provided by other PCMH team members. Their experience in drug therapy assessments, medication therapy management, and population health has documented benefits, both in terms of patient health outcomes and health care costs. Through collaborative care, pharmacists can assist physicians and other prescribers in medication management and thus improve prescriber productivity and patient access to care. Pharmacists are engaged in PCMHs through both employment and contractual arrangements. While some pharmacists serve a unique PCMH, others work within practice networks that serve practices within a geographical area. Financial support for pharmacist-provided services includes university funding, external grant funding, payer reimbursement, and allocation of PCMH incentives and bonus funds. There is growing support for pharmacist integration into PCMHs; however, more convincing cost-effectiveness data, as well as performance measures requiring the unique skills of pharmacists, may be needed before pharmacist-provided PCMH services become more widely adopted. Given the continued evolution of the PCMH model of care, ongoing opportunities exist for pharmacists to create an optimal care model that is suitable for PCMHs and rewarding for their profession.

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Improving Herpes Zoster Vaccination Rates Through Use of a Clinical Pharmacist and a Personal Health Record

Cited by 39 publications

References 13 publications

National and State-Specific Shingles Vaccination Among Adults Aged ≥60 Years

National and State-Specific Shingles Vaccination Among Adults Aged ≥60 Years

Using e-technologies in clinical trials

The role of the pharmacist in patient-centered medical home practices: current perspectives

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