Building An Adult Immunization Practice: The Primary Care Physician's Role In Desease Prevention


	Release Date: June 15, 2012 Expiration Date: June 15, 2013

EDUCATIONAL OVERVIEW
Vaccines have been highly effective in eliminating or significantly reducing the occurrence of many once-common diseases. However, barriers to immunization, particularly in older adults, have played a significant factor in the rising incidence of some vaccine-preventable diseases. Cost, reduced accessibility to vaccines, and complex or changing schedules for adult immunization have contributed to low immunization rates in at-risk adult populations. This can lead to significant clinical consequences and economic impacts due to vaccine-preventable diseases and related complications.

Addressing Barriers to Adult Immunization:
The Role of Primary Care Providers
Primary care providers (PCPs) play an important role in administering recommended vaccines to their patients. However, PCPs must not only be knowledgeable about
vaccines, they must incorporate systems in their offices to record, remind, and recall patients for vaccinations. They must also clearly communicate vaccine benefits and risks while understanding those factors that affect a patient’s acceptance and perception of vaccines.

To improve overall adult immunization rates, it is critical to expand PCP knowledge and competence regarding vaccine-preventable diseases and recommended vaccines. Building healthcare provider awareness of current immunization guidelines as well as the benefits of immunization is critical to improving vaccination rates. PCPs can lead the way in these efforts by educating their patients about vaccine-preventable diseases and taking proactive measures within their clinical practice to ensure patients are vaccinated when indicated.

TARGET AUDIENCE
This educational activity is designed for PCPs, including family physicians, internists, nurse practitioners, physician assistants, nurses, and other allied healthcare practitioners who are at the forefront of managing adults at risk for vaccine-preventable diseases.

LEARNING OBJECTIVES
After reviewing all modules of this activity, healthcare professionals will be able to:

Recognize the clinical consequences of vaccine-preventable diseases in adults
Identify adult patients who will benefit from vaccination
Educate patients about the benefits of vaccines
Reduce and remove system- and patient-related barriers to vaccination

EDUCATIONAL FORMAT
This enduring material is based on a series of live workshops presented at selected American Academy of Family Physicians (AAFP) state chapter meetings.

Through evidence-based presentations and faculty discussions, this 10-module online activity, provides evidence supporting the importance of adult vaccination and describes the current recommendations. It also addresses the challenges PCPs may face in promoting adult vaccination and identifies strategies that can be implemented in clinical practice to assist their immunization efforts.

This online activity has 10 modules.
All 10 modules must be completed to receive credit:

MODULE 1: Pneumococcal Disease

MODULE 2: Influenza

MODULE 3: Pertussis

MODULE 4: Herpes Zoster

MODULE 5: Don’t Neglect the Other Adult Vaccines

MODULE 6: Adult Immunization: Role of the Clinician

MODULE 7: The Medical Home: Utilizing a Multidisciplinary Approach to Adult Immunization

MODULE 8: Quality Improvement and Meeting the Managed Care Requirements in Adult Immunization

MODULE 9: Utilizing a Combination of Interventions in Improving Adult Immunization

MODULE 10: Role of the Pharmacist in Adult Immunization

Note:

1. This enduring material is based on a series of live workshops presented between December 2011-April 2012.

2. If you have received credit for attending the live workshop by the same name, you are not eligible to receive credit for this enduring material.

3. Note that The Task Force on Community Preventive Services recommendations presented in Module 9 have been updated since this activity was released. Current recommendations on combination and standalone interventions are available at:
www.thecommunityguide.org/vaccines/universally/index.html.

AUDIENCE RESPONSE RESULTS
During the live meetings held between December 2011-April 2012, participants were asked a series of questions related to vaccines and vaccine administration. Review their responses below to see how your responses compare.

1. How many patients do you see each week?

2. On average how many adult patients do you
administer a vaccine to each week?

3. Which of the following vaccines is most
frequently administered in your practice?

4. Approximately what percentage of your patients
refuse vaccines that you recommend?

FACULTY

	Thomas M. File, Jr., MD, MS, MACP, FIDSA, FCCP Chair, Division of Infectious Disease Summa Health System Akron, OH Professor, Internal Medicine Master Teacher; Chair, Infectious Disease Section Northeast Ohio Medical University Rootstown, OH

	Debra A. Goff, PharmD, FCCP Clinical Associate Professor Infectious Disease Specialist The Ohio State University Medical Center Columbus, OH

	Michael D. Hogue, PharmD, FAPhA Associate Professor and Chair Department of Pharmacy Practice Samford University McWhorter School of Pharmacy Birmingham, AL

	Robert H. Hopkins, Jr., MD, FACP, FAAP Professor of Internal Medicine and Pediatrics University of Arkansas for Medical Sciences, College of Medicine Program Director, Combined Internal Medicine- Pediatrics Residency Practice Director, General Internal Medicine Clinics Little Rock, AR

	Patrick Joseph, MD, FIDSA, FSHEA Associate Clinical Professor of Medicine University of California, San Francisco San Francisco, CA

	Donald E. Low, MD, FRCPC Microbiologist-in-Chief University Health Network/Mount Sinai Hospital Medical Director, Public Health Laboratories Ontario Agency for Health Protection and Promotion Toronto, Ontario

	George G. Zhanel, PharmD, PhD Professor Medical Microbiology, Faculty of Medicine University of Manitoba Coordinator Antibiotic Resistance Program Clinical Microbiology, Health Sciences Center Winnipeg, Canada

CE Accreditation
Physicians
This activity has been planned and implemented in accordance with the Essential Areas and Elements and Accreditation Policies of the Accreditation Council for Continuing Medical Education through the joint sponsorship of the National Foundation for Infectious Diseases (NFID) and Vemco MedEd, LLC. The National Foundation for Infectious Diseases is accredited by the Accreditation Council for Continuing Medical Education to provide continuing medical education for physicians.

NFID designates this enduring material for a maximum of 2.0 AMA PRA Category 1 Credits™. Physicians should claim only the credit commensurate with the extent of their participation in the activity.

Method of Participation and Instruction for Credit
There are no fees for participating in or receiving credit for this online educational activity. For information on applicability and acceptance of continuing education credit for this activity, please consult your professional licensing board.

Review the complete CME information including target audience, learning objectives, and disclosures.
Review all of the modules (partial credit will not be issued) and the course materials.
Complete the online Post-Test and Evaluation. Note that you must receive a passing score of at least 80% to receive credit.
A printable or downloadable certificate will be available upon successful completion of the online Post-Test and Evaluation.

For questions, please contact cme@nfid.org.

Disclosures
As an organization accredited by the Accreditation Council for Continuing Medical Education, it is the policy of NFID to ensure balance, independence, objectivity, and scientific rigor in all of its educational activities. All individuals in a position to control the content of the activity have disclosed all relevant financial relationships with the manufacturer(s) of any commercial product(s) and/or provider(s) of commercial services discussed in an educational presentation and/or with any commercial supporters of the activity. Disclosure information is reviewed in advance to manage and resolve any real or perceived conflict of interest that may affect the balance and scientific integrity of an educational presentation.

Faculty
Thomas File, Jr., MD, MS serves as a consultant/advisor to Astellas/Theravance, Cerexa/Forest, DaiichiSankyo, GlaxoSmithKline, Merck & Co., Inc., Nabriva, Pfizer Inc., and Tetraphase and has received grants for clinical research from Cempra, Pfizer Inc., and The Medicines Company.

Debra A. Goff, PharmD serves as a consultant/advisor to Cubist, Forest, Merck & Co., Inc., and Optimer. She serves as speaker for Merck & Co., Inc.

Michael D. Hogue, PharmD serves as a consultant/advisor for Pfizer Inc. and as a speaker for Merck & Co., Inc.

Robert H. Hopkins, Jr., MD has no relevant financial relationships to disclose.

Patrick Joseph, MD has no relevant financial relationships to disclose.

Donald E. Low, MD has no relevant financial relationships to disclose.

George G. Zhanel, PharmD, PhD has received grants for clinical research from Abbott, Achaogen, Affinium, Astellas, AstraZeneca, Cangene, Cubist, Forest/Cerexa, Merck & Co., Inc., and Pfizer Inc.

Planning Committee Members
Len Novick (NFID) owns stock, stock options, or bonds from Cubist, Novavax, Pfizer Inc., and ViroPharma.

Marla Dalton (NFID) has no relevant financial relationships to disclose.

Susan J. Rehm, MD (NFID) serves as an advisor or consultant for Merck & Co., Inc. and Pfizer Inc. and as a speaker for Genentech.

All other employees of NFID and Vemco MedEd have no relevant financial relationships to disclose.

Disclaimer
The opinions expressed in this educational activity are those of the faculty and do not reflect the views of NFID and Vemco MedEd. This educational activity may discuss off-label and/or investigational uses and dosages for therapeutic products/procedures that have not been approved by the United States Food and Drug Administration (FDA). NFID and Vemco MedEd do not recommend the use of any product/procedure outside of the labeled indications. A qualified healthcare professional should be consulted before using any therapeutic product/procedure discussed. Clinicians should verify all information and data before treating patients or employing any therapies described in this continuing education activity. Please refer to the prescribing information for each product/procedure for approved indication, contraindications, and warnings.

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Sponsorship
This activity is jointly sponsored by

Commercial Support

This activity is supported by an educational grant to the National Foundation for Infectious Diseases from Merck & Co., Inc.