Pneumoccocal Vaccination
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| Performance Measure: Pneumococcal Vaccination - OPR-Related Measure: No |
Percentage of clients [ 1 ] with HIV infection who ever received pneumococcal vaccine
Number of HIV-infected clients who ever received a pneumococcal vaccine
Number of HIV-infected clients who had:
- no documented evidence [ 2 ] of vaccination; and
- a medical visit with a provider with prescribing privileges [ 3 ] at least once in the measurement year
Patients with CD4 counts < 200 cells/mm3 within the measurement year
- Is the client HIV-infected? (Y/N)
- If yes, is there documentation in the chart that the client ever received the pneumococcal vaccine? (Y/N)
- Electronic Medical Record/Electronic Health Record
- CAREWare, Lab Tracker or other electronic data base
- HIVQUAL reports on this measure for grantee under review
- Medical record data abstraction by grantee of a sample of records
- Billing records
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| National Goals, Targets, or Benchmarks for Comparison |
National HIVQUAL Data [ 4 ]
| |
2003 |
2004 |
2005 |
2006 |
2007 |
| Top 10% |
100.0% |
95.8% |
97.5% |
100.0% |
100.0% |
| Top 25% |
92.6% |
90.8% |
93.9% |
93.8% |
95.1% |
| Mean* |
79.9% |
73.0% |
77.1% |
79.8% |
80.9% |
*from HAB data base
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| Outcome Measures for Consideration |
- Incidence of pneumococcal infection in the clinic population
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| Basis for Selection and Placement in Group 3 |
Bacterial pneumonia is a common cause of HIV-associated morbidity and appears with greater incidence in HIV-infected persons than in the non-infected population. Several risk factors are associated with an increased risk of bacterial pneumonia including CD4 count, injection drug use and smoking. [ 5 ]
The measure was placed in Group 3 because it overlaps and focuses on similar aspects of care (vaccination) that were previously captured in measures included in Group 2.
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| US Public Health Service Guidelines |
"HIV-infected adults and adolescents who have a CD4 count of ≥ 200 cells/ u L should be administered a single dose of 23-valent polysaccharide pneumococcal vaccine (PPV) unless they have received this vaccine during the previous five years (AII)". Revaccination can be considered for patients who were initially immunized when their CD4 T lymphocyte counts were < 200 cells/ u L in response to HAART (CIII). [ 6 ]
[1] "Clients" includes all clients aged 13 years or older.
[2] Evidence of vaccination could include personal, school, physician, or immunization records or registries.
[3] A "provider with prescribing privileges" is a health care professional who is certified in their jurisdiction to prescribe medications.
[4] Pneumococcal vaccine (http://www.hivguidelines.org/admin/files/qoc/hivqual/proj%20info/HQNatlAggScrs3Yrs.pdf)
[5] Centers for Disease Control and Prevention. Guidelines for Prevention and Treatment of Opportunistic Infections in HIV-Infected Adults and Adolescents. June 18, 2008; 1-134. (http://aidsinfo.nih.gov/contentfiles/Adult_OI.pdf)
[6] Ibid.
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