The Expanding Role of Community Pharmacists In Identification of at-Risk Patients and Provision of Pneumococcal Vaccinations

Background:  Patients age 65 years and over and age 64 years and under with chronic conditions are at increased risk for influenza and pneumonia.  Among these at-risk patients, the incidence of invasive pneumococcal disease (IPD) is 40 per 100,000 with a mortality rate of about 1 in 20.  Additionally, the annual direct and indirect costs of IPD are estimated at $3.7 billion and $1.8 billion. In recent years there have been widespread marketing and public health initiatives to expand the rate of influenza immunizations.  As more people seek influenza vaccinations at community pharmacies, pharmacists have the ability to identify at-risk patients and provide pneumococcal vaccinations (PPSV).

Objectives:  Evaluate the impact of Walgreens pharmacists identifying and counseling at-risk patients on the importance of PPSV.

Methods:  Walgreens pharmacy claim data from 11/15/2009 thru 11/14/2010 were included in the analysis.  Influenza vaccinations and PPSV were defined as pharmacy fills for the relevant vaccinations.   At-risk patients were identified by age and via pharmacy claims.  A benchmark medical and pharmacy claims database including ~425,000 members, age > 64, and ~370,000 members age ≤ 64 with a chronic condition was used to derive a comparison PPSV rate typical of traditional care delivery.

Results:  Between 8/1/2010 and 11/14/2010, 2,095,748 patients received influenza immunizations at Walgreens of which 1,374,380 were considered at-risk.  Among the at-risk patients, 65,608 received PPSV; a rate of 4.77%.  This is significantly greater than the PPSV benchmark rate of 2.90% for the corresponding influenza immunization period of August to November (p<.0001).

Conclusions:  Walgreens pharmacists are successful at identifying at-risk patients and providing additional immunization services.  The rate of PPSV was greater than the benchmark population during the immunization period.  These results support the expanding role of community pharmacists in the provision of wellness and prevention services.