{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,4,11]],"date-time":"2026-04-11T20:59:24Z","timestamp":1775941164498,"version":"3.50.1"},"reference-count":27,"publisher":"Wiley","issue":"1","license":[{"start":{"date-parts":[[2012,12,27]],"date-time":"2012-12-27T00:00:00Z","timestamp":1356566400000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Arthritis &amp; Rheumatism"],"published-print":{"date-parts":[[2013,1]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Objective<\/jats:title><jats:p>Pneumococcal vaccination is important for patients taking immunosuppressive medications, but prior studies suggest that most patients do not undergo vaccination. The aim of this study was to evaluate the effects of a point\u2010of\u2010care paper reminder form as a quality improvement (QI) strategy to increase the numbers of immunosuppressed patients being kept up\u2010to\u2010date with pneumococcal vaccination in a rheumatology practice.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>Selected rheumatologists at 5 ambulatory practice sites received a point\u2010of\u2010care paper reminder form to be applied to patients who were not up\u2010to\u2010date with pneumococcal vaccination. Interrupted time\u2010series analyses were used to measure the effect of the intervention on the pneumococcal vaccination rates among patients, comparing the rates in the intervention group with those in a control group of rheumatologists who did not receive the intervention. Adjusted Cox proportional hazards models were examined to identify independent predictors of being up\u2010to\u2010date with pneumococcal vaccination.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>We evaluated a total of 3,717 patients (66.0% with rheumatoid arthritis) who were taking immunosuppressive medications (74.1% women, mean age 53.7 years). Rheumatologists who received the intervention had a significant increase in the rate of patients who were up\u2010to\u2010date with pneumococcal vaccination, from 67.6% to 80.0% (<jats:italic>P<\/jats:italic> = 0.006), in the time period following the intervention, compared to a rate that remained stable, from 52.3% to 52.0% (<jats:italic>P<\/jats:italic> = 0.90), among patients in the nonintervention control group during this same time period. In regression models, positive predictors of being up\u2010to\u2010date with pneumococcal vaccination at the patient level included the following: having received the intervention (hazard ratio [HR] 3.58, 95% confidence interval [95% CI] 2.46\u20135.20), having a primary care physician affiliated with Brigham and Women's Hospital (HR 1.68, 95% CI 1.44\u20131.97), having a diagnosis of diabetes mellitus (HR 1.57, 95% CI 1.02\u20132.41), and being age 56\u201365 years at baseline, compared to age \u226445 years (HR 1.24, 95% CI 1.01\u20131.51).<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>A QI strategy involving a simple point\u2010of\u2010care paper reminder form significantly increased the rate of being up\u2010to\u2010date with pneumococcal vaccination among patients receiving immunosuppressive medications in our rheumatology practices over a 6\u2010month period.<\/jats:p><\/jats:sec>","DOI":"10.1002\/art.37716","type":"journal-article","created":{"date-parts":[[2012,10,8]],"date-time":"2012-10-08T17:26:21Z","timestamp":1349717181000},"page":"39-47","source":"Crossref","is-referenced-by-count":53,"title":["Increasing pneumococcal vaccination for immunosuppressed patients: A cluster quality improvement trial"],"prefix":"10.1002","volume":"65","author":[{"given":"Sonali P.","family":"Desai","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Bing","family":"Lu","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Lara E.","family":"Szent\u2010Gyorgyi","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Anna 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