Evaluation of Patient Adherence to Vaccine and Screening Recommendations during Community Pharmacist-led Medicare Annual Wellness Visits in a Family Medicine Clinic

Abstract

Background: The Centers for Medicare and Medicaid Services initiated annual wellness visits (AWV) to reduce healthcare costs and improve preventive healthcare for beneficiaries. Provider time constraints and varying preferences to perform AWVs have limited its clinical implementation in some areas, affording pharmacists an opportunity to expand their role. Objective: To evaluate patient adherence to pharmacist recommendations for vaccinations and preventive screenings in an annual wellness visit service at a family medicine clinic in northeast Mississippi. Methods: This study included patients receiving at least one vaccination or screening recommendation during an AWV. Investigators provided vaccination (influenza, pneumococcal and herpes zoster) and screening (mammograms, DEXA, and colorectal cancer) recommendations based on current guidelines. For services not provided in-clinic, investigators contacted outside facilities 45 days post-visit to confirm adherence to recommendations. Primary endpoints included the composite adherence rate of all recommendations and percentage of patients achieving the 60% goal composite adherence rate. Secondary endpoints included individual vaccination and screening adherence rates. Results: Investigators recommended 715 interventions to a total of 254 patients, of which 239 were completed within 45 days for a 33.4 percent composite adherence rate. 20.1 percent of all participants achieved the goal composite adherence rate (60%). Overall, participants were 30.5 and 41 percent adherent to all vaccinations and preventive screening recommendations, respectively. Conclusion: Pharmacists providing AWVs increased patient access to preventive health recommendations. Although, adherence to recommendations remains a challenge and warrants further study. The findings and limitations observed in this study have identified opportunities for future research to evaluate pharmacist-led AWV services.

Keywords: Annual Wellness Visits; Centers of Medicare and Medicaid Services; immunizations; pharmacist-led; preventive health screenings.

Figure 1:

AWV Adherence Rate Comparison