Evaluation of hospital admission criteria for community-acquired pneumonia patients

The aim of this study was to evaluate the diagnostic and therapeutic procedures used to assess community acquired pneumonia (CAP) patients. Patients can be deemed high-risk or low-risk, which can affect if they are treated as an inpatient or outpatient. This study was conducted because many healthcare providers do not follow guideline recommendations for pneumonia severity assessment, which determines site of treatment. Therefore many low-risk patients are treated inpatient, which is more expensive than outpatient and delays the patient’s return to work.

CURB-65 is a score to evaluate admission criteria of CAP patients. The main outcome studied was if CURB-65 was being properly utilized for the prevention of mortality and morbidity in CAP patients. This retrospective descriptive and comparative study looked at 403 patients’ files from 2007-2012. Only 35 patients or 8.6% had all the information necessary to calculate their CURB-65, showing that the model is not well used. Results showed that physicians focused more on the presence of coexisting disease, raised vital signs, or laboratory values instead of pneumonia severity when making their assessments for initial site of treatment. Pharmacoeconomic analysis showed that mild cases that are treated inpatient resulted in extra cost and longer delay to normal activity or work without any added benefit. This shows that physicians need to be more adherent to pneumonia severity assessment guidelines and collecting information to complete CURB-65. How do you think a proper pneumonia severity diagnosis would affect the pharmacist’s role in drug therapy and counseling?

Alomar MJ, Al-Ahmad MM. Evaluation of hospital admission criteria for community-acquired pneumonia patients at a private hospital in the UAE. Journal of Pharmacy Research. 2013;7(4)-267-270.

Impact of the RxVaccinate program for pharmacy-based pneumococcal immunization

Pneumonia is a disease that is very prevalent within society and is one of the leading causes of death, particularly in adults aged 65 or older. A very easy way to prevent contraction and spread of pneumonia is to receive the appropriate vaccinations at the correct time in a patient’s life. Pharmacists are providing an increasingly higher proportion of these vaccines, and are projected to administer even more in the future. This study looked at the effectiveness of a program called RxVaccinate, created by APhA, which was designed to compare the effectiveness of two different types of education programs in increasing the amount of pneumococcal vaccines administered.

The two programs involved in the study were a series of self-directed training webinars and the webinars combined with expert coaching sessions. The webinar focused on the current pneumococcal immunization recommendations, benefits of getting the vaccine, how to identify high-risk patients and provide counseling to them. The coaching sessions involved outlining action plans for the pharmacists and how to implement them. One group of pharmacists received only the self-directed training on pneumococcal vaccines, while the other group received coaching sessions in addition to the self-directed webinars. This study found that while both programs significantly increased the number of pneumococcal vaccines administered at each community pharmacy, the pharmacists who received both the webinar and the coaching session trainings increased the amount of pneumococcal vaccines administered than the pharmacists who only received the webinar training, with a P value of 0.032.

This study is really interesting to me because at my work (in a community pharmacy), we are frequently assigned self-directing online learning modules to teach us about new programs or educate us on new compliance policies within the company. I know for the sake of efficiency it is easier to send us online modules, but it does make it easier for pharmacy team members to dismiss them or not take the training as seriously as they would if the same information was presented in an expert-led training session. However, for something as important as teaching pharmacists the proper methods to identify, counsel, and administer the vaccine to patients, it is definitely necessary to have an in-person training session. As more advanced technological methods of teaching emerges, how do you think the effectiveness of pharmacists’ training will be affected? Do you think these types of online learning modules will completely replace in-person training sessions, or do you think they will only be used as more of a supplement to these sessions?

Westrick SC, Owen J, Hagel H et al. Impact of the RxVaccinate program for pharmacy-based pneumococcal immunization: A cluster-randomized controlled trial. J Am Pharm Assoc. 2016; 56:29-36.

http://www.japha.org/article/S1544-3191(15)00011-4/abstract

 

Pharmacist Education and Inpatient Influenza and Pneumococcal Vaccination Acceptance Rates

The United States is vastly affected by pneumococcus pneumonia, invasive pneumococcal infections, and seasonal influenza each and every year. Although there are vaccines that prevent these diseases, approximately 70 million high-risk adults are vulnerable to pneumococcus by by remaining unvaccinated. The number of deaths related to influenza has been steadily increasing in the United States since 1990. If patients qualify, patients can receive both the influenza and pneumonia vaccinations to protect themselves from these disease, however, less than half of adults 18 years of older were vaccinated during the 2012 to 2013 flu season. It is apparent that pharmacists, as immunizers in the community setting, are increasing the current vaccination rates in the population today.

A study was conducted to determine just how effective pharmacist-driven education programs were at increasing vaccination rates. Patients in a small community hospital who initially rejected vaccinations upon admission were educated by pharmacists and pharmacy interns and reoccurred the vaccination. As a result, 39.2% of patients changed there minds and decided to receive the influence and pneumococcal pneumonia vaccines.

This study proves the importance of patient education. Pharmacists need to provide patients with all the available information in order for patients to make the right decisions in regards to their health care. I am proud to be going in to a profession that has such a big influence on its patient population.

Journal of Pharmacy Practice (2016): n. pag. Web.

Link to article