Pharmacist Impact on Pneumococcal Polysaccharide Vaccination Rates in Patients With Diabetes in a Supermarket Pharmacy Chain

Three geographically and socioeconomically diverse Kroger pharmacies will be selected in the
greater Richmond area. Eligible patients include patients with diabetes between the ages of
19 and 64 and patients who have filled a prescription for at least one diabetes medication in
the past 90 days. An NDC (National Drug Code) activity report will be run through Kroger
internal reporting to identify patients who have filled a prescription for a diabetes
medication in the past 90 days. Excluded patients include those with a known history
pneumococcal polysaccharide vaccination, and patients with an allergy to any component of the
pneumococcal polysaccharide vaccine. All patients who are deemed eligible will have their
immunization history assessed by verifying immunization records in their Kroger medication
profile, in the Virginia Immunization Information System (VIIS) or with their primary care
physician. The percentage of patients vaccinated with the pneumococcal polysaccharide vaccine
in the three Kroger pharmacies will be calculated prior to the start of the intervention
period.

Eligible patients will have a pop-up note added to their patient profile in the Kroger
system. The pop-up note will indicate that the patient is eligible for education on the
pneumococcal polysaccharide vaccine. When an eligible patient presents to the pharmacy for
prescription pick up or drop off, the pop-up note will notify the technician to get a
pharmacist for education. The pharmacist will educate the patient on the vaccine and then
recommend that the patient receives the vaccine. If the patient accepts the recommendation,
the pharmacist will then follow Kroger policies and protocol and administer the pneumococcal
polysaccharide vaccine to the patient. Standard procedure of administering a pneumococcal
vaccine at Kroger includes having the patient complete and sign a vaccination consent form.
The consent form consists of questions that assess the patients current health status,
immunocompromising conditions, allergies and pregnancy status This indicates to the
pharmacist whether the vaccine requested is appropriate for the patient. The pharmacist will
review the Kroger consent form and administer the pneumococcal vaccine, using sterile
injection technique, if there are no contraindications. After the patient receives the
vaccine or declines the vaccine recommendation, the pharmacist will then ask the patient to
complete a brief survey. After completion or refusal of the survey, the pharmacist will
document the date the survey was completed or denied and if the pneumococcal vaccine was
given. After the patient encounter has ended, the pharmacist will edit the pop-up note in the
patient profile to document the date the patient was educated, and no further intervention is
needed.

Inclusion Criteria:

- Patients with diabetes

- Patients who have filled a prescription for at least one diabetes medication in the
past 90 days

Exclusion Criteria:

- Patients with a known history pneumococcal polysaccharide vaccination

- Patients with an allergy to any component of the pneumococcal polysaccharide vaccine