Session Time: 4:30pm-5:30pm
Presentation Time: 5:05pm-5:10pm
*Purpose: Infectious diseases are a leading cause of morbidity and mortality among patients with end-stage liver disease (ESLD). Vaccination data of ESLD patients pre- and post-transplantation is scarce. This study was created to evaluate the impact of pharmacist intervention on vaccination rates within the ESLD population.
*Methods: This study was a retrospective, quasi-experiment evaluating the impact of a pharmacist driven immunization clinic at a large academic medical center established in February 2018. Patients listed for liver transplant between August 2016 and July 2019 were separated into pre- and post-implementation cohorts based on timing of immunization clinic implementation. All patients in the post-implementation group were evaluated by pharmacist for need of hepatitis A, hepatitis B, and pneumococcal conjugate and polysaccharide vaccines according to Advisory Committee on Immunization Practices recommendations; if needed, vaccines were offered at future visits.
*Results: A total of 240 patients were included with 120 in each group. Demographics are reported in table 1. Vaccine series initiation rate prior to transplantation was higher in the post-implementation group: 54.9% vs. 15.6%; p<0.001. When evaluating each vaccine series separately, significantly more patients received hepatitis B (41.7 vs. 12.6%, p<0.001) and pneumococcal conjugate vaccination (26.9 vs. 14.4%, p=0.046) in the post-implementation group as compared to the pre-implementation group. The percentage of patients receiving hepatitis A (27.8 vs. 17.1%) and pneumococcal polysaccharide vaccination (30.6 vs. 18.9%) were higher in the post-implementation group, but not statistically significant. Additionally, a higher percentage of patients in the post-implementation group were considered to be up-to-date on their vaccines at end of follow up (31.4 vs. 9%, p<0.001).
*Conclusions: The pharmacist-driven immunization clinic significantly increased the incidence of vaccine series initiation in ESLD patients, as well as more patients were considered up-to-date at end of follow up. With appropriate vaccination, these patients are at a decreased risk of vaccine-preventable infections.
|Pre-implementation (N=120)||Post-implementation (N=120)||P value|
|Mean age, year (range)||58 (25-95)||58 (27-71)||0.612|
|Male sex, n (%)||72 (60)||72 (60)||1.0|
|Caucasian, n (%)||79 (66)||78 (65)||0.244|
|Updated vaccines OR documented immunity, n (%)||79 (66)||12 (10)||0.649|
To cite this abstract in AMA style:Poparad-Stezar A, Summers B, Fitzmaurice M, Hakamiun K, Sulejmani N, Jantz A. Impact of a Pharmacist-driven Immunization Clinic on Vaccination Rates in Pre-liver Transplant Patients [abstract]. Am J Transplant. 2021; 21 (suppl 3). https://atcmeetingabstracts.com/abstract/impact-of-a-pharmacist-driven-immunization-clinic-on-vaccination-rates-in-pre-liver-transplant-patients/. Accessed June 12, 2021.
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