<?xml version="1.0" encoding="ISO-8859-1"?><article xmlns:mml="http://www.w3.org/1998/Math/MathML" xmlns:xlink="http://www.w3.org/1999/xlink" xmlns:xsi="http://www.w3.org/2001/XMLSchema-instance">
<front>
<journal-meta>
<journal-id>2184-0628</journal-id>
<journal-title><![CDATA[Gazeta Médica]]></journal-title>
<abbrev-journal-title><![CDATA[Gaz Med]]></abbrev-journal-title>
<issn>2184-0628</issn>
<publisher>
<publisher-name><![CDATA[Círculo Médico]]></publisher-name>
</publisher>
</journal-meta>
<article-meta>
<article-id>S2184-06282020000400335</article-id>
<article-id pub-id-type="doi">10.29315/gm.v7i4.377</article-id>
<title-group>
<article-title xml:lang="pt"><![CDATA[Vacinação Antipneumocócica Conjugada 13-Valente nos Utentes com DPOC: Um Projeto de Melhoria da Qualidade]]></article-title>
<article-title xml:lang="en"><![CDATA[13-Valent Pneumococcal Conjugate Vaccine in Patients with COPD: A Quality Improvement Project]]></article-title>
</title-group>
<contrib-group>
<contrib contrib-type="author">
<name>
<surname><![CDATA[Araújo]]></surname>
<given-names><![CDATA[Vera Alexandra]]></given-names>
</name>
<xref ref-type="aff" rid="Aff"/>
<xref ref-type="aff" rid="Aaf"/>
</contrib>
<contrib contrib-type="author">
<name>
<surname><![CDATA[Barbosa]]></surname>
<given-names><![CDATA[Ana Sofia Vieira]]></given-names>
</name>
<xref ref-type="aff" rid="Aff"/>
<xref ref-type="aff" rid="Aaf"/>
</contrib>
</contrib-group>
<aff id="Af1">
<institution><![CDATA[,Unidade de Saúde Familiar Lethes  ]]></institution>
<addr-line><![CDATA[Ponte de Lima ]]></addr-line>
<country>Portugal</country>
</aff>
<aff id="Af2">
<institution><![CDATA[,Unidade Local de Saúde do Alto Minho  ]]></institution>
<addr-line><![CDATA[Ponte de Lima ]]></addr-line>
<country>Portugal</country>
</aff>
<pub-date pub-type="pub">
<day>30</day>
<month>12</month>
<year>2020</year>
</pub-date>
<pub-date pub-type="epub">
<day>30</day>
<month>12</month>
<year>2020</year>
</pub-date>
<volume>7</volume>
<numero>4</numero>
<fpage>335</fpage>
<lpage>340</lpage>
<copyright-statement/>
<copyright-year/>
<self-uri xlink:href="http://scielo.pt/scielo.php?script=sci_arttext&amp;pid=S2184-06282020000400335&amp;lng=en&amp;nrm=iso"></self-uri><self-uri xlink:href="http://scielo.pt/scielo.php?script=sci_abstract&amp;pid=S2184-06282020000400335&amp;lng=en&amp;nrm=iso"></self-uri><self-uri xlink:href="http://scielo.pt/scielo.php?script=sci_pdf&amp;pid=S2184-06282020000400335&amp;lng=en&amp;nrm=iso"></self-uri><abstract abstract-type="short" xml:lang="pt"><p><![CDATA[Resumo  Introdução:  Os cuidados de saúde primários são fundamentais na gestão da doença pulmonar obstrutiva crónica (DPOC). A vacina antipneumocócica conjugada 13-valente (VPC13) está recomendada pela redução da bacteriemia e doença invasiva pneumocócica. O nosso objetivo foi avaliar e melhorar a prescrição, adesão e cobertura com a VPC13 nos utentes com DPOC de uma Unidade de Saúde Familiar (USF). Definiu-se como critério de qualidade o aumento da taxa de cobertura com VPC13 para 25% (adesão à prescrição de 100%).  Métodos:  Realizou-se um estudo longitudinal prospetivo para caracterização da prescrição, adesão e cobertura da VPC13 nos utentes da USF Lethes com DPOC (dados até 30/06/2017). Desenvolveu-se um projeto de melhoria da qualidade que contemplou apresentação dos resultados, formação em serviço, seguida de discussão em grupo e definição de estratégias corretoras. Foi atualizado o folheto relativo à DPOC e distribuído aos utentes. Após a intervenção replicou-se a avaliação, considerando registos até 31/12/2018.  Resultados e discussão:  O projeto incluiu 126 utentes. Inicialmente a VPC13 tinha sido prescrita a 24 utentes (19%), dos quais 21 (16,7%) efetuaram a vacinação (adesão de 87,5%). Após a intervenção, a VPC13 foi prescrita a mais 14 utentes, com adesão de 100%. Obteve-se um aumento absoluto da taxa de cobertura vacinal de 16,7% para 27,8% (correspondendo a um aumento percentual relativo de 66,7%).  Conclusão:  Dada a importância da VPC13, a intervenção focou-se na melhoria da prescrição com resultados significativos e impacto na cobertura vacinal. Os resultados obtidos são uma base para investigação futura quanto aos determinantes da prescrição relacionados com o médico e utente.]]></p></abstract>
<abstract abstract-type="short" xml:lang="en"><p><![CDATA[Abstract  Introduction:  Primary health care are essential in the management of chronic obstructive pulmonary disease (COPD). 13-valent conjugated pneumococcal vaccine (CPV13) is recommended in order to reduce bacteremia and invasive pneumococcal disease. The aim of this work is to evaluate and improve CPV13 prescription, compliance and coverage in patients with COPD at a Family Health Unit (FHU). The quality criterion was defined as increasing the coverage rate with PCV13 to 25% and compliance to the prescription of 100%.  Methods:  We conducted a prospective longitudinal study to characterize the prescription, compliance and coverage of CPV13 in patients with COPD at FHU Lethes (considered data until 30/06/2017). A quality improvement project was developed. It included presentation of results to FHU professionals, followed by discussion and definition of corrective strategies. The COPD leaflet was updated and distributed to patients. After the intervention, the evaluation was replicated, considering records until 31/12/2018.  Results and discussion:  The project included 126 patients. Initially, CPV13 had been prescribed to 24 users (19%) and 21 (16.7%) had been vaccinated (87.5% compliance). After the intervention, CPV13 was prescribed to 14 patients, with 100% compliance. We verified an increase of absolute coverage with PCV13 from 16.7% to 27.8% (corresponding to na increase in relative percentage of 66.7%).  Conclusion:  Given the importance of CPV13, the intervention focused on improving prescription with significant results and impact on vaccination coverage. The results obtained are a basis for future research regarding the determinants in CPV13 prescription not only related to the doctors but also the patient.]]></p></abstract>
<kwd-group>
<kwd lng="pt"><![CDATA[Doença Pulmonar Obstrutiva Crónica]]></kwd>
<kwd lng="pt"><![CDATA[Infeções Pneumocócicas/prevenção e controlo]]></kwd>
<kwd lng="pt"><![CDATA[Vacinas Conjugadas]]></kwd>
<kwd lng="pt"><![CDATA[Vacinas Pneumocócicas]]></kwd>
<kwd lng="en"><![CDATA[Pneumococcal Infections/prevention &amp; control]]></kwd>
<kwd lng="en"><![CDATA[Pneumococcal Vaccines]]></kwd>
<kwd lng="en"><![CDATA[Pulmonary Disease, Chronic Obstructive]]></kwd>
<kwd lng="en"><![CDATA[Vaccines, Conjugate]]></kwd>
</kwd-group>
</article-meta>
</front><back>
<ref-list>
<ref id="B1">
<label>1</label><nlm-citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname><![CDATA[Halbert]]></surname>
<given-names><![CDATA[RJ]]></given-names>
</name>
<name>
<surname><![CDATA[Isonaka]]></surname>
<given-names><![CDATA[S]]></given-names>
</name>
<name>
<surname><![CDATA[George]]></surname>
<given-names><![CDATA[D]]></given-names>
</name>
<name>
<surname><![CDATA[Iqbal]]></surname>
<given-names><![CDATA[A]]></given-names>
</name>
</person-group>
<article-title xml:lang=""><![CDATA[Interpreting COPD prevalence estimates: what is the true burden of disease?]]></article-title>
<source><![CDATA[Chest]]></source>
<year>2003</year>
<volume>123</volume>
<page-range>1684-92</page-range></nlm-citation>
</ref>
<ref id="B2">
<label>2</label><nlm-citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname><![CDATA[Bárbara]]></surname>
<given-names><![CDATA[C]]></given-names>
</name>
<name>
<surname><![CDATA[Rodrigues]]></surname>
<given-names><![CDATA[F]]></given-names>
</name>
<name>
<surname><![CDATA[Dias]]></surname>
<given-names><![CDATA[H]]></given-names>
</name>
<name>
<surname><![CDATA[Cardoso]]></surname>
<given-names><![CDATA[J]]></given-names>
</name>
<name>
<surname><![CDATA[Almeida]]></surname>
<given-names><![CDATA[J]]></given-names>
</name>
<name>
<surname><![CDATA[Matos]]></surname>
<given-names><![CDATA[MJ]]></given-names>
</name>
</person-group>
<article-title xml:lang=""><![CDATA[Chronic obstructive pulmonary disease prevalence in Lisbon, Portugal: the burden of obstructive lung disease study]]></article-title>
<source><![CDATA[Rev Port Pneumol]]></source>
<year>2013</year>
<volume>19</volume>
<page-range>96-105</page-range></nlm-citation>
</ref>
<ref id="B3">
<label>3</label><nlm-citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname><![CDATA[Wilkinson]]></surname>
<given-names><![CDATA[T]]></given-names>
</name>
<name>
<surname><![CDATA[Wedzicha]]></surname>
<given-names><![CDATA[JA]]></given-names>
</name>
</person-group>
<article-title xml:lang=""><![CDATA[Strategies for improving outcomes of COPD exacerbations]]></article-title>
<source><![CDATA[Int J Chron Obstruct Pulmon Dis]]></source>
<year>2006</year>
<volume>1</volume>
<page-range>335-42</page-range></nlm-citation>
</ref>
<ref id="B4">
<label>4</label><nlm-citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname><![CDATA[Halpin]]></surname>
<given-names><![CDATA[DM]]></given-names>
</name>
<name>
<surname><![CDATA[Miravitlles]]></surname>
<given-names><![CDATA[M]]></given-names>
</name>
<name>
<surname><![CDATA[Metzdorf]]></surname>
<given-names><![CDATA[N]]></given-names>
</name>
<name>
<surname><![CDATA[Celli]]></surname>
<given-names><![CDATA[B]]></given-names>
</name>
</person-group>
<article-title xml:lang=""><![CDATA[Impact and prevention of severe exacerbations of COPD: a review of the evidence]]></article-title>
<source><![CDATA[Int J Chron Obstruct Pulmon Dis]]></source>
<year>2017</year>
<volume>12</volume>
<page-range>2891-908</page-range></nlm-citation>
</ref>
<ref id="B5">
<label>5</label><nlm-citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname><![CDATA[Rohde]]></surname>
<given-names><![CDATA[G]]></given-names>
</name>
<name>
<surname><![CDATA[Wiethege]]></surname>
<given-names><![CDATA[A]]></given-names>
</name>
<name>
<surname><![CDATA[Borg]]></surname>
<given-names><![CDATA[I]]></given-names>
</name>
<name>
<surname><![CDATA[Kauth]]></surname>
<given-names><![CDATA[M]]></given-names>
</name>
<name>
<surname><![CDATA[Bauer]]></surname>
<given-names><![CDATA[TT]]></given-names>
</name>
<name>
<surname><![CDATA[Gillissen]]></surname>
<given-names><![CDATA[A]]></given-names>
</name>
</person-group>
<article-title xml:lang=""><![CDATA[Respiratory viruses in exacerbations of chronic obstructive pulmonary disease requiring hospitalisation: a case-control study]]></article-title>
<source><![CDATA[Thorax]]></source>
<year>2003</year>
<volume>58</volume>
<page-range>37-42</page-range></nlm-citation>
</ref>
<ref id="B6">
<label>6</label><nlm-citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname><![CDATA[Ogunbayo]]></surname>
<given-names><![CDATA[OJ]]></given-names>
</name>
<name>
<surname><![CDATA[Russell]]></surname>
<given-names><![CDATA[S]]></given-names>
</name>
<name>
<surname><![CDATA[Newham]]></surname>
<given-names><![CDATA[JJ]]></given-names>
</name>
<name>
<surname><![CDATA[Heslop-Marshall]]></surname>
<given-names><![CDATA[K]]></given-names>
</name>
<name>
<surname><![CDATA[Netts]]></surname>
<given-names><![CDATA[P]]></given-names>
</name>
<name>
<surname><![CDATA[Hanratty]]></surname>
<given-names><![CDATA[B]]></given-names>
</name>
</person-group>
<article-title xml:lang=""><![CDATA[Understanding the factors affecting self-management of COPD from the perspectives of healthcare practitioners: a qualitative study]]></article-title>
<source><![CDATA[NPJ Prim Care Respir Med]]></source>
<year>2017</year>
<volume>27</volume>
<page-range>54</page-range></nlm-citation>
</ref>
<ref id="B7">
<label>7</label><nlm-citation citation-type="">
<source><![CDATA[Global Initiative for Chronic Obstrutive Lung Disease (GOLD).]]></source>
<year></year>
</nlm-citation>
</ref>
<ref id="B8">
<label>8</label><nlm-citation citation-type="journal">
<collab>Direção Geral da Saúde</collab>
<article-title xml:lang=""><![CDATA[Norma de Orientação Clínica nº011/2015 de 6/11/2015. Lisboa:]]></article-title>
<source><![CDATA[DGS]]></source>
<year>2015</year>
</nlm-citation>
</ref>
<ref id="B9">
<label>9</label><nlm-citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname><![CDATA[Jiménez-García]]></surname>
<given-names><![CDATA[R]]></given-names>
</name>
<name>
<surname><![CDATA[Ariñez-Fernandez]]></surname>
<given-names><![CDATA[MC]]></given-names>
</name>
<name>
<surname><![CDATA[Hernández-Barrera]]></surname>
<given-names><![CDATA[V]]></given-names>
</name>
<name>
<surname><![CDATA[Garcia-Carballo]]></surname>
<given-names><![CDATA[MM]]></given-names>
</name>
<name>
<surname><![CDATA[de Miguel]]></surname>
<given-names><![CDATA[AG]]></given-names>
</name>
<name>
<surname><![CDATA[Carrasco-Garrido]]></surname>
<given-names><![CDATA[P]]></given-names>
</name>
</person-group>
<article-title xml:lang=""><![CDATA[Compliance with influenza and pneumococcal vaccination among patients with chronic obstructive pulmonary disease consulting their medical practitioners in Catalonia, Spain]]></article-title>
<source><![CDATA[J Infect]]></source>
<year>2007</year>
<volume>54</volume>
<page-range>65-74</page-range></nlm-citation>
</ref>
<ref id="B10">
<label>10</label><nlm-citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname><![CDATA[Chiatti]]></surname>
<given-names><![CDATA[C]]></given-names>
</name>
<name>
<surname><![CDATA[Barbadoro]]></surname>
<given-names><![CDATA[P]]></given-names>
</name>
<name>
<surname><![CDATA[Marigliano]]></surname>
<given-names><![CDATA[A]]></given-names>
</name>
<name>
<surname><![CDATA[Ricciardi]]></surname>
<given-names><![CDATA[A]]></given-names>
</name>
<name>
<surname><![CDATA[Di Stanislao]]></surname>
<given-names><![CDATA[F]]></given-names>
</name>
<name>
<surname><![CDATA[Prospero]]></surname>
<given-names><![CDATA[E]]></given-names>
</name>
</person-group>
<article-title xml:lang=""><![CDATA[Determinants of influenza vaccination among the adult and older Italian population with chronic obstructive pulmonary disease: a secondary analysis of the multipurpose ISTAT survey on health and health care use]]></article-title>
<source><![CDATA[Hum Vaccin]]></source>
<year>2011</year>
<volume>7</volume>
<page-range>1021-5</page-range></nlm-citation>
</ref>
<ref id="B11">
<label>11</label><nlm-citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname><![CDATA[Mantero]]></surname>
<given-names><![CDATA[M]]></given-names>
</name>
<name>
<surname><![CDATA[Aliberti]]></surname>
<given-names><![CDATA[S]]></given-names>
</name>
<name>
<surname><![CDATA[Azzari]]></surname>
<given-names><![CDATA[C]]></given-names>
</name>
<name>
<surname><![CDATA[Moriondo]]></surname>
<given-names><![CDATA[M]]></given-names>
</name>
<name>
<surname><![CDATA[Nieddu]]></surname>
<given-names><![CDATA[F]]></given-names>
</name>
<name>
<surname><![CDATA[Blasi]]></surname>
<given-names><![CDATA[F]]></given-names>
</name>
<name>
<surname><![CDATA[Di Pasquale]]></surname>
<given-names><![CDATA[M]]></given-names>
</name>
</person-group>
<article-title xml:lang=""><![CDATA[Role of Streptococcus pneumoniae infection in chronic obstructive pulmonary disease patients in Italy]]></article-title>
<source><![CDATA[Ther Adv Respir Dis]]></source>
<year>2017</year>
<volume>11</volume>
<page-range>403-7</page-range></nlm-citation>
</ref>
<ref id="B12">
<label>12</label><nlm-citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname><![CDATA[Sehatzadeh]]></surname>
<given-names><![CDATA[S]]></given-names>
</name>
</person-group>
<article-title xml:lang=""><![CDATA[Influenza and pneumococcal vaccinations for patients with chronic obstructive pulmonary disease (COPD): an evidence-based review]]></article-title>
<source><![CDATA[Ont Health Technol Assess Ser]]></source>
<year>2012</year>
<volume>12</volume>
<page-range>1-64</page-range></nlm-citation>
</ref>
<ref id="B13">
<label>13</label><nlm-citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname><![CDATA[Vila-Córcoles]]></surname>
<given-names><![CDATA[A]]></given-names>
</name>
<name>
<surname><![CDATA[Ochoa-Gondar]]></surname>
<given-names><![CDATA[O]]></given-names>
</name>
<name>
<surname><![CDATA[de Diego]]></surname>
<given-names><![CDATA[C]]></given-names>
</name>
<name>
<surname><![CDATA[Satué]]></surname>
<given-names><![CDATA[E]]></given-names>
</name>
<name>
<surname><![CDATA[Vila-Rovira]]></surname>
<given-names><![CDATA[A]]></given-names>
</name>
<name>
<surname><![CDATA[Aragón]]></surname>
<given-names><![CDATA[M]]></given-names>
</name>
</person-group>
<article-title xml:lang=""><![CDATA[Pneumococcal vaccination coverages by age, sex and specific underlying risk conditions among middle-aged and older adults in Catalonia, Spain, 2017]]></article-title>
<source><![CDATA[Euro Surveill]]></source>
<year>2019</year>
<volume>24</volume>
<page-range>1800446</page-range></nlm-citation>
</ref>
<ref id="B14">
<label>14</label><nlm-citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname><![CDATA[Castro Marques]]></surname>
<given-names><![CDATA[S]]></given-names>
</name>
<name>
<surname><![CDATA[Maia]]></surname>
<given-names><![CDATA[A]]></given-names>
</name>
<name>
<surname><![CDATA[Veloso]]></surname>
<given-names><![CDATA[L]]></given-names>
</name>
</person-group>
<article-title xml:lang=""><![CDATA[A importância da vacinação dos adultos com diabetes tipo 2 na prevenção da doença invasiva pneumocócica]]></article-title>
<source><![CDATA[Rev Port Endocrinol Diabetes Metab]]></source>
<year>2016</year>
<volume>11</volume>
<page-range>60-8</page-range></nlm-citation>
</ref>
<ref id="B15">
<label>15</label><nlm-citation citation-type="">
<person-group person-group-type="author">
<name>
<surname><![CDATA[Dias]]></surname>
<given-names><![CDATA[A]]></given-names>
</name>
</person-group>
<source><![CDATA[Avaliação da prescrição da vacina pneumocócica nos doentes diabéticos vigiados na USF Aqueduto]]></source>
<year>2011</year>
<publisher-loc><![CDATA[Porto ]]></publisher-loc>
</nlm-citation>
</ref>
<ref id="B16">
<label>16</label><nlm-citation citation-type="">
<collab>Healthy people</collab>
<source><![CDATA[The Office of Disease Prevention and Health Promotion]]></source>
<year>2020</year>
</nlm-citation>
</ref>
</ref-list>
</back>
</article>
