Targeted intervention improves vaccination rate of asplenic patients
Guideline-based care for asplenic patients can be improved by targeted interventions, a recent study suggests. Furthermore, three of four recommended vaccinations have increased with the creation of a clinic designed for asplenic patients.
To show that a targeted intervention can improve vaccination rates in a population of asplenic veterans, researchers identified surgically asplenic patients actively receiving care via a database search. Letters were mailed to these individuals, encouraging them to attend an existing travel clinic with a new process designed for asplenic patients.
Patients were given further education on the risks of asplenia and proper preventive precautions in the said clinic. In addition, vaccination history was obtained, and patients were administered any additional indicated vaccines.
A total of 113 patients were identified from the database search. Providers identified and referred an additional 14 asplenic patients to the travel clinic, and two were referred prior to the planned splenectomy. The first-year referral rate to the clinic was 29 percent (38 of 129 asplenic patients).
The first year of the intervention resulted in increases in the rates of three of four recommended vaccinations: pneumococcal conjugate (19 to 55 percent; p<0.001); Haemophilus influenza type B (19 to 35 percent; p=0.007); and meningococcal vaccine (24 to 43 percent; p=0.002). The rate of pneumococcal polysaccharide vaccination rose from 91 to 93 percent (p=0.62).
The use of targeted intervention may be applicable to other healthcare systems with similar numbers of asplenic patients, according to researchers.
“Asplenic patients are at risk for severe infections, but adherence to recommended preventive education and vaccination is poor,” they added.