============================================================================= Run Date: JAN 30, 2015 Designation: PXRM*2*55 Package : PXRM - CLINICAL REMINDERS Priority: Mandatory Version : 2 SEQ #36 Status: Released Compliance Date: MAR 02, 2015 ============================================================================= Associated patches: (v)PXRM*2*26 <<= must be installed BEFORE `PXRM*2*55' (v)PX*1*201 <<= must be installed BEFORE `PXRM*2*55' Subject: PNEUMOCOCCAL IMMUNIZATION UPDATES Category: - Routine Description: ============ In August 2014, the Advisory Committee on Immunization Practices (ACIP) updated recommendations for use of PCV13 to include patients age 65 and over. This patch updated the existing reminders to include that new recommendation. The spacing between a dose of PCV13 and PPSV23 is now recommended to be 6 months (8 weeks minimum but preferably 6 months). PNEUMOCOCCAL VACCINE-NAIVE PERSONS ================================== ACIP recommends that adults aged >=19 years with immunocompromising conditions, functional or anatomic asplenia, CSF leaks, or cochlear implants, and who have not previously received PCV13 or PPSV23, should receive a dose of PCV13 first, followed by a dose of PPSV23 at least 8 weeks later. Subsequent doses of PPSV23 should follow current PPSV23 recommendations for adults at high risk. Specifically, a second PPSV23 dose is recommended 5 years after the first PPSV23 dose for persons aged 19-64 years with functional or anatomic asplenia and for persons with immunocompromising conditions. Additionally, those who received PPSV23 before age 65 years for any indication should receive another dose of the vaccine at age 65 years, or later if at least 5 years have elapsed since their previous PPSV23 dose. PREVIOUS VACCINATION WITH PPSV23 ================================ Adults aged >=19 with immunocompromising conditions, functional or anatomic asplenia, CSF leaks, or cochlear implants, who previously have received >=1 doses of PPSV23 should be given a PCV13 dose >=1 year after the last PPSV23 dose was received. For those who require additional doses of PPSV23, the first such dose should be given no sooner than 8 weeks after PCV13 and at least 5 years after the most recent dose of PPSV23. This patch does the following during installation: 1. Updates the existing reminder definitions: VA-PNEUMOCOCCAL IMMUNIZATION PPSV23 VA-PNEUMOCOCCAL IMMUNIZATION PCV13 VA-OB PNEUMOCOCCAL PPSV23 INDICATIONS VA-OB PNEUMOCOCCAL PCV13 INDICATIONS 2. Updates the existing Reminder Dialogs: VA-PNEUMOCOCCAL IMMUNIZATION PPSV23 PNEUMOVAX VA-PNEUMOCOCCAL IMMUNIZATION PCV13 PREVNAR 3. Updates the existing Taxonomies if not already done by PXRM*2.0*50: VA-PNEUMOC DZ RISK - HIGHEST/NOT IMMUNO COMP VA-PNEUMOC DZ RISK - IMMUNOCOMPROMISED VA-PNEUMOC DZ RISK - HIGH VA-PNEUMOC DZ RISK - CHEMOTHERAPY (includes drug classes classes and drugs) 4. Immunization: PNEUMOCOCCAL CONJUGATE PCV13 - No mnemonic is being sent out Updates made in this patch: PCV13 due for over 65; PPSV23 not applicable over age 65 until PCV13 is given and 6 months has passed unless the patient has a contraindication/other reason to not get PCV13. Text information for PCV13 over 65 added shown below: PCV13 'incorrect diagnosis' option now suppressed for over 65 just like that option is for PPSV23. Finding 10 in PPSV23 now turns off the reminder in all cases for 6 months. Wait 6 months after PCV13 to give any dose of PPSV23. Drug statuses have been added to chemotherapy to include any administration of drug in the past 6 months in order to make MHV and PCV13/PPSV23 the same. Removed 1 M due in advance Pneumococcal indications - fixed a bug where the time periods in the object were different than in the reminder - use same time period on object as in the reminder. PCV13 Object from changed to ------------ ---- ---------- IC 4y 2y Highest 4y 10y Chemo drugs 90D 6M PPCV23 Object from changed to ------------- ---- ---------- Chemo drugs 90D 6M Added text related to requiring documentation of prior vaccines before recording them. RECOMMENDATIONS: ---------------- In August 2014, the ACIP updated recommendations for use of PCV13 to include patients age 65 and over. This patch updates the existing reminders to include this new recommendation. Associated Remedy Tickets: =========================== 1. INC000001077495 - Pneumococcal Content Updates Associated NSR(s): ================== N/A Participating Test Site(s): =========================== Erie VAMC, PA James J. Peters VAMC, Bronx, NY Jerry L. Pettis Memorial VAMC, Loma Linda, CA Louisville VAMC, KY VA Maryland HCS REMEDY OVERVIEW: ================= 1. INC000001077495 - Pneumococcal Content Updates Problem: --------- In August 2014, the ACIP updated recommendations for use of PCV13 to include patients age 65 and over. This patch updates the existing reminders to include this new recommendation. Resolution: ----------- This patch, PXRM*2*55, contains two routines, PXRMP55E and PXRMP55I. They are init tasks that add new entries to the REMINDER EXCHANGE (#811.8) file and the contents of these entries are installed during the post-init. These routines can be deleted after the install. Build Components: ================= N/A Data Dictionary: ================ N/A Software & Documentation Retrieval Instructions: ================================================ This patch is being distributed as a host file. The name of the host file is PXRM_2_0_55.KID. This file should be downloaded in ASCII format. The preferred method for obtaining these files is to use File Transfer Protocol (FTP) to download them from: ftp://download.vista.domain.ext/. This transmits the files from the first available FTP server. Sites may also elect to retrieve the files directly from a specific server as follows: Albany ftp.domain.ext Hines ftp.domain.ext Salt Lake City ftp.domain.ext The Install and Setup Guide is also available on the above servers. It is available as .pdf format. This file should be downloaded in BINARY format. File Name: Description: Protocol: ========== ============ ========= PXRM_2_0_55_IG.PDF PXRM*2.0*55 Install BINARY and Setup Guide PXRM_2_0_55.KID PXRM*2.0*55 Host File ASCII Documentation can also be found on the VistA Documentation Library (VDL) at: http://www.domain.ext/vdl/ Installation: ============= This patch can be loaded with users on the system. Installation will take five minutes. Refer to the Install and Setup Guide, PXRM_2_0_55_IG.PDF, for complete details. 1. Use the "Load a Distribution" option on the KIDS installation menu. When prompted to enter a host file type in PXRM_2_0_55.KID 2. On the KIDS menu under the 'INSTALLATION' menu, use the following options, as desired: Print Transport Global Compare Transport Global to Current System Verify checksums in Transport Global Backup a Transport Global 3. On the KIDS menu under the 'INSTALLATION' menu, use the following option to install the patch: Install Package(s) When prompted for INSTALL NAME, use PXRM*2.0*55 4. When prompted "Want KIDS to INHIBIT LOGONs during the install? NO//," respond 'NO'. 5. When prompted "Want to DISABLE Scheduled Options, Menu Options, and Protocols? NO// respond 'NO'. 6. After successful installation, the following init routines may be deleted PXRMP55E PXRMP55I Routine Information: ==================== The second line of each of these routines now looks like: ;;2.0;CLINICAL REMINDERS;**[Patch List]**;Feb 04, 2005;Build 215 The checksums below are new checksums, and can be checked with CHECK1^XTSUMBLD. Routine Name: PXRMP55E Before: n/a After: B744071 **55** Routine Name: PXRMP55I Before: n/a After: B2486423 **55** ============================================================================= User Information: Entered By : Date Entered : OCT 30, 2014 Completed By: Date Completed: JAN 29, 2015 Released By : Date Released : JAN 30, 2015 ============================================================================= Packman Mail Message: ===================== No routines included