Continuous quality improvement of pneumococcal vaccination in risk groups
DOI:
https://doi.org/10.32385/rpmgf.v42i1.14186Keywords:
Pneumococcal vaccine, Pneumococcal infection, Vaccination, Primary health care, Quality improvementAbstract
Introduction: Pneumococcal disease is an important cause of morbimortality potentially preventable through vaccination. Although widely implemented in the pediatric population, pneumococcal vaccination remains underused in adults belonging to increased risk groups for invasive pneumococcal disease (IPD).
Objectives: To assess and improve the pneumococcal vaccination profile in risk groups within a Portuguese family health unit (USF).
Methods: Quasi-experimental, with pre- and post-intervention assessment, in a northern Portugal USF. The target population was defined by age ≥65 years or diagnosis coded by ICPC-2 corresponding to a risk group for IPD, in accordance with the respective clinical guidance standard. The first evaluation was carried out in July 2023, through analysis of the vaccination profile of a representative sample. The six-month intervention period included a clinical session aimed at the multidisciplinary team, consultation support material, a moment of self-reflection, and the application of opportunistic vaccination recommendation strategies. The second evaluation took place in May 2024. The quality criteria for the pneumococcal vaccination rate were defined as: insufficient if <15%, sufficient if 15-25%, good if 25-50%, very good if 50-75%, and excellent if >75%.
Results: Initially, a pneumococcal vaccination rate of 24.6% (sufficient quality standard), variable between risk groups for IPD was found. In the second evaluation, a vaccination rate of 29.6% was achieved (good quality standard), 23.2% being prescribed and administered during the intervention period, with 100% adherence.
Conclusion: Despite the improvement in the quality standard of vaccination, it will be necessary to extend the intervention period and reflect on the determinants of prescription and vaccination adherence related to the doctor and the patient, to promote a more expressive and sustained increase in pneumococcal vaccination in risk groups.
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