Outcomes
infection
INFECTION, DISEASE, SECONDARY
Primary outcome was the adherence to preventive measures six months after the intervention compared to standard of care in the historical control group (assessed at least six months after splenectomy yielding similar time frames for preventive measures in both study arms). Adherence was measured by the study-specific PrePSS score, which assesses the following items: (a) receipt of guideline-conform sequential pneumococcal vaccination and (b) guideline-conform meningococcal vaccinations, (c) prescription and availability of stand-by antibiotics for emergency treatment and (d) handing out of and carrying a medical alert card. A total of 16 international experts in the care for asplenic patients were asked to rate the proposed guideline-derived items in terms of their importance in infection prevention. The scoring system employed in this study is derived from the median ratings of the nine experts who provided feedback. Additional details on the development of the PrePSS score have been described previously [Secondary outcomes included proximal HAPA-related variables such as patient’s risk perception, self-efficacy or action planning and more distal outcomes such as disease knowledge and health-related quality of life. Evaluation of these secondary outcomes will be reported elsewhere.