Prevention of Pneumococcal Infections: Impact Collaborative Medico-pharmaceutical Care Structured to Improve Vaccination Coverage of Patients at Risk.

Centre Hospitalier Universitaire de Nīmes646 enrolled

Overview

In France, Streptococcus pneumoniae is the leading agent bacterial involved in community lung disease and meningitis. The frequency of these infections and their mortality increase significantly in those at risk such as patients with certain chronic diseases, immunocompromised or on immunosuppressive therapy. This population, despite regular monitoring, has a limited pneumococcal vaccine coverage of around 20%. By carrying out a reconciliation of treatments upon admission to hospital, the clinical pharmacist can detect those without up to date pneumococcal vaccination status. The goal of this management is to make the patient aware of the need for vaccination and organization upon return home. Thus, this limited pneumococcal vaccination coverage would benefit from intervention by regional clinical pharmacy activities. The study investigators want to study the impact of a structured medico-pharmaceutical collaboration on pneumococcal vaccination of patients with risk on discharge from hospital. The investigators hypothesize that this collaboration in patients at risk of infection with pneumococcus could significantly increase their anti-pneumococcal vaccination coverage

Study Type

INTERVENTIONAL

Allocation

RANDOMIZED

Purpose

OTHER

Masking

SINGLE

Enrollment

646

Conditions

Streptococcus Pneumoniae Infection

Interventions

Eligibility

Sex: ALLMin age: 18 Years

Medical Language ↔ Plain English

Inclusion Criteria: * The patient must have given their free and informed oral consent * The patient must be a member or beneficiary of a health insurance plan * The patient is admitted to full hospitalization in a surgical or medical department. * The patient will benefit from a reconciliation of drug treatments. * The patient is considered at risk of pneumococcal infection according to the recommendations of March 2017 of the High Council of Public Health (HCSP) * Pneumococcal vaccination is not up to date according to the HCSP 2017 recommendations. Exclusion Criteria: * The subject is participating in a category 1 interventional study * The patient has participated in a category 1 trial within the previous 3 months or is in a period of exclusion determined by a previous study * It is impossible to give the subject informed information * The patient is under safeguard of justice or state guardianship * The patient is not in a fit state to express consent * The patient is pregnant, parturient or breast feeding

Locations (9)

CH Alès Cévennes

Alès, France

CH de Bagnols sur Cèze

Bagnols-sur-Cèze, France

CH de Montauban

Montauban, France

CHU de Montpellier

Montpellier, France

CHU de Nimes

Nîmes, France

CH de Perpignan

Perpignan, France

CH Comminges Pyrénées

Saint-Gaudens, France

CH du Bassin de Thau

Sète, France

CHU de Toulouse

Toulouse, France

Outcomes

Primary Outcomes

Full vaccination coverage (2 doses) between groups

Yes/No, confirmed by the administrator

Time frame: 6 months after discharge

Secondary Outcomes

Full vaccination coverage (2 doses) between groups, stratified by type of establishment (University hospital vs hospital) and by service (Medicine vs Surgery)

Yes/No, confirmed by the administrator

Time frame: 6 months after discharge

Partial vaccination coverage (1st dose only) between groups and stratified by type of establishment (University hospital vs hospital) and by service (Medicine vs Surgery)

Yes/No, confirmed by the administrator

Time frame: 6 months after discharge

Record of both vaccines being dispensed by the pharmacy between groups and stratified by type of establishment (University hospital vs hospital) and by service (Medicine vs Surgery)

Yes/No according to Système national d'information inter-régimes de l'Assurance maladie (SNIIRAM) database

Time frame: 6 months after last follow-up visit

Concordance between vaccines dispensed and vaccines recorded in the SNIRRAM database between groups and stratified by type of establishment (University hospital vs hospital) and by service (Medicine vs Surgery)

Yes/No

Time frame: 6 months after discharge

Prescription of vaccines at discharge by the doctor between groups and stratified by type of establishment (University hospital vs hospital) and by service (Medicine vs Surgery)

Yes/No

Time frame: at discharge (average 5 days after hospitlization)

Notification of requirement for vaccine between groups and stratified by type of establishment (University hospital vs hospital) and by service (Medicine vs Surgery)

Yes/No

Time frame: at discharge (average 5 days after hospitlization)

Transmission of letter highlighting the absence of vaccination by the pharmacy to the patient's doctor between groups and stratified by type of establishment (University hospital vs hospital) and by service (Medicine vs Surgery)

Yes/No

Time frame: at discharge (average 5 days after hospitlization)