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Ilyse Haberman, Elisabeth Cohen, Zachary Elkin, Judith Goldberg, Xiaochun Li, Eliana Castano, Lisa Park, Michael Perskin; Increasing coverage of a vaccine against herpes zoster at New York University Langone Medical Center and Bellevue Hospital. Invest. Ophthalmol. Vis. Sci. 2013;54(15):2895.
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© ARVO (1962-2015); The Authors (2016-present)
To increase coverage following recommended guidelines of the vaccine against herpes zoster at New York University Langone Medical Center (NYULMC) by studying barriers to vaccination before and after introducing interventions to facilitate usage.
An IRB approved follow-up survey of internal medicine physicians was administered to assess knowledge, attitudes, practices, and perceived barriers regarding the vaccine against herpes zoster. This survey was administered 1 year after the baseline survey as reported at ARVO 2012. Interventions included education, increased availability at the outpatient pharmacy with the option for administration by a nurse, and implementation of electronic medical record alerts and reminders. The survey began October 1, 2012 and was extended due to flood damage from Hurricane Sandy from November 30 to December 21, 2012. Pharmacy data for vaccine administration was reported for the months prior to and following the interventions.
Results from the follow-up survey of 262 internal medicine physicians and documented changes in vaccine use at the NYULMC pharmacy from the period prior to the baseline survey will be presented. To date, the response rate to the survey is 23.6% (62/262). After interventions, the percentage of physicians who prescribe to fewer than 10% of eligible patients age 60 years or older declined 19.4% (47.7% to 28.3%), and the percentage of physicians who prescribe to fewer than 50% declined 15.4% (70.1% to 54.7%). The percentage of physicians who believe zoster vaccination is a clinical priority remained stable (69.3% to 72.2%). Of the perceived barriers identified from the baseline survey, physicians who reported cost decreased 9.3% (77.8% to 68.5%), and those who reported competing clinical focuses decreased 23.1% (50.9% to 27.8%). Following increased vaccine availability at the outpatient pharmacy, along with a physician and patient education campaign, vaccine prescriptions per month at the outpatient pharmacy increased from an average of 47 (range 33 to 59) in the three months prior to the baseline survey to an average of 134.4 (103 to 169) during the 10 months following the survey (286% increase in vaccines administered per month).
Understanding and addressing the barriers to the use of the herpes zoster vaccine can increase its usage in accordance with existing national recommendations.
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