Impact of a student pharmacist-directed pilot intervention on influenza vaccination documentation and administration rates in older adults receiving parenteral anticancer therapy.

Abstract

71 Background: Annual influenza vaccination is recommended for individuals 6 months and older. Older adults are at high-risk of developing influenza and complications associated with the virus. However, < 50% of patients with cancer receive the influenza vaccine annually. In previous work at our institution, a quality improvement project identified that only 40% of adult patients initiating parenteral anticancer therapy between September and December 2017 were documented to have received the influenza vaccine. Therefore, a multidisciplinary student pharmacist-directed pilot intervention was developed to improve influenza vaccine documentation and administration rates, and we sought to investigate the impact of this intervention. Methods: All adult patients (≥65 years old) scheduled for parenteral anticancer therapy during November 2018 were screened for influenza vaccination documentation. Patients were identified by reviewing infusion center schedule. Under supervision of board-certified oncology pharmacists, two student pharmacists evaluated influenza vaccination documentation in the institution/network electronic medical record (EMR) and outside records. Patients with unknown vaccination history were identified for interview by pharmacy students. The student pharmacists collaborated with oncology nurses and clinicians to order and administer influenza vaccine to patients who agreed to vaccination. Influenza vaccination status was updated in the EMR following record reviews/interviews. Results: Student pharmacists screened 617 patient EMRs and interviewed 124 patients to verify vaccination status. Furthermore, 33 patients received influenza vaccination as a direct result of student pharmacist intervention. Overall, rate of influenza vaccination status documentation was 60.5%. Conclusions: Compared with historic data, we found promising results for a student pharmacist-directed pilot intervention, which demonstrated the potential to improve influenza vaccination status documentation and administration among older adults receiving parenteral anticancer therapy.

Quality Improvement Interventions to Enhance Vaccine Uptake in Cancer Patients: A Systematic Review

“…In total, 13 studies were analyzed for this review. [13][14][15][16][17][18][19][20][21][22][23][24][25]…”

“…17 Four studies evaluated interventions targeting patients who routinely inquired about their vaccine status. 15,17,18,24 These interventions consisted of inquiry of vaccination status at outside sites, 15 placing visual cues in patients' medication reconciliation lists, 17 screening vaccine status at initial oncology clinic visits, 18 secondary screening during chemotherapy teaching sessions, 18 and identifying patients with unknown vaccine status for inquiry. 12…”

“…Two studies used best practice alerts, notifications visible upon entering a patient's electronic medical record, to remind providers of patients who had not received appropriate vaccination. 17 McGinnis et al 14 Wong et al 15 Olshefski et al 16 Grivas et al 17 Draliuk et al 19 Lee et al 22 Chang et al 23 Vaccine status inquiry 4 Wong et al 15 Olshefski et al 16 Delacruz et al 18 Kim et al 24 Healthcare workers Reviewed eligible patients 8 Freedman et al 13 Wong et al 15 Olshefski et al 16 Delacruz et al 18 Draliuk et al 19 Rostamnjad et al 20 Chang et al 23 Kim et al 24 Medical team education 7 Freedman et al 13 McGinnis et al 14 Wong et al 15 Olshefski et al 16 Delacruz et al 18 Draliuk et al 19 Chang et al 23 Medical provider reminders 6 Freedman et al 13 Wong et al 15 Olshefski et al 16 Grivas et al 17 Journal for Healthcare Quality…”

“…Eight studies evaluated interventions that reviewed eligible patients before their visit 13,15,16,[18][19][20]23,24 The studies varied who reviewed eligible patients versus who received the list of eligible patients. For example, one study notes the electronic medical record daily lists automatically, 13 whereas another study notes that the clinical pharmacist reviewed the patient record and sent the information to providers and nurses.…”