5138.1: Wednesday, November 15, 2000 - Board 2

Abstract #11811

Office-based systems for pneumococcal vaccination delivery: Can we put prevention into practice

Douglas Shenson, MD, MPH1, John Quinley, MD, MPH2, and Donna DiMartino, RN, MSN1. (1) SPARC, Sickness Prevention Achieved through Regional Collaboration, P.O. Box 746, Lakeville, CT 06039, 8604352896, dshenson@channel1.com, (2) IPRO, 1979 Marcus Ave, Lake Success, NY 11042-1002

Background: Data from a county-wide survey of Dutchess County, NY, indicate that 88.9% of individuals age=50 have had a routine check up by a physician in the past two years. However, only 36.9% of patients age=65 have ever received polysaccharide pneumococcal vaccine (PPV).

Objective: To assess physician attitudes towards PPV, and to determine how practices document and monitor delivery of the vaccine.

Methods: Visits by a representative of a local disease prevention program (SPARC) were made to 33 adult medicine practices in Dutchess County, NY. A questionnaire was used to obtain data relating to attitudes towards the delivery of PPV, and about current office PPV protocols. The project received technical support and funding from IPRO, New York's peer review organization.

Results: There is skepticism among some physicians regarding the usefulness of PPV, and many are uncertain about current recommendations for revaccination. In approximately half the practices delivery of PPV is not recorded on a summary sheet, but only in the progress note. In multi-physician practices, each physician has his/her own system of charting. The challenge of developing a uniform system is seen as prohibitively difficult. Reminder systems from managed care organizations or public health agencies that arrive unsolicited are generally discarded.

Conclusion: There is no uniformity in office-based approaches to the delivery of PPV despite the availability of data-driven protocols for the delivery of this immunization. Administering PPV is perceived by many physicians as a discretionary intervention, rather than as a standard public health measure.

Learning Objectives: Participants will describe current status of office-based tracking of polysaccharide pneumonia vaccination. Participants will identify barriers to the systematic delivery of PPV within medical practices

Keywords: Prevention, Quality Improvement

Presenting author's disclosure statement:
Organization/institution whose products or services will be discussed: None
I do not have any significant financial interest/arrangement or affiliation with any organization/institution whose products or services are being discussed in this session.

The 128th Annual Meeting of APHA