13-Valent Pneumococcal Conjugate Vaccine in Patients with COPD: A Quality Improvement Project

Abstract

INTRODUCTION: Primary health care are essential in the management of chronic obstructive pulmonary disease (COPD). 13-valent conjugated pneumococcal vaccine (CPV13) is recommended in order to reduce bacteremia and invasive pneumococcal disease.
The aim of this work is to evaluate and improve CPV13 prescription, compliance and coverage in patients with COPD at a Family Health Unit (FHU). The quality criterion was defined as increasing the coverage rate with PCV13 to 25% and compliance to the prescription of 100%.
METHODS: We conducted a prospective longitudinal study to characterize the prescription, compliance and coverage of CPV13 in patients with COPD at FHU Lethes (considered data until 30/06/2017). A quality improvement project was developed. It included presentation of results to FHU professionals, followed by discussion and definition of corrective strategies. The COPD leaflet was updated and distributed to patients. After the intervention, the evaluation was replicated, considering records until 31/12/2018.
RESULTS AND DISCUSSION: The project included 126 patients. Initially, CPV13 had been prescribed to 24 users (19%) and 21 (16.7%) had been vaccinated (87.5% compliance). After the intervention, CPV13 was prescribed to 14 patients, with 100% compliance. We verified an increase of absolute coverage with PCV13 from 16.7% to 27.8% (corresponding to an increase in relative percentage of 66.7%).
CONCLUSION: Given the importance of CPV13, the intervention focused on improving prescription with significant results and impact on vaccination coverage. The results obtained are a basis for future research regarding the determinants in CPV13 prescription not only related to the doctors but also the patient.