Ulcerative Colitis Resource Center

Ulcerative Colitis Resource Center

July 09, 2015
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Patient-directed educational intervention increases vaccination rates in IBD patients

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A simple, written educational form to determine vaccination status and provide same-day influenza and pneumococcal pneumonia vaccines significantly increased vaccination rates in patients with inflammatory bowel disease, according to research data.

“Patients with inflammatory bowel disease (IBD) are at increased risk for vaccine preventable illnesses,” Francis A. Farraye, MD, MSc, professor of medicine at Boston Medical Center, told Healio Gastroenterology. “In our quality improvement project we sought to increase influenza and pneumoccocal vaccination rates in patients with IBD. Our intervention demonstrated that a simple educational form could be used to substantially increase vaccination rates.”

Francis A. Farraye

Although IBD patients have an increased risk for vaccine-preventable illnesses, their vaccination rates are low. Therefore, Farraye, a Healio Gastroenterology Peer Perspective Board Member, and colleagues developed a simple intervention aimed at increasing the influenza and pneumococcal pneumonia vaccination rates to 60% in IBD patients at the Center for Digestive Disorders at Boston Medical Center.

The intervention consisted of a one-page form to determine patient vaccination status and provide education about vaccinations. If they reported they were not vaccinated or unsure of their vaccination status, they were offered vaccination at the time of their visit (only during influenza season for influenza vaccine).

The investigators compared influenza vaccination rates during three flu seasons, and compared pneumococcal pneumonia vaccination rates during the 6-months before the intervention was introduced and the 15-months after implementation.

During the pilot period on Wednesdays and Thursdays from December 2012 through January 2013, mean vaccinations per week increased from 2.6 to 4.1 for influenza and from 0.2 to 5 for pneumococcal pneumonia (both P < .05), and there was no chance observed on days the form was not used.

The form was then implemented into practice from February 2013 to May 2014, during which time 692 IBD patients (mean age, 45.2 years; 53.2% female) were seen. Overall the percentage of patients who reported having an influenza vaccination increased from 23% to 47%, and patients who reported having a pneumococcal pneumonia vaccination increased from 21% to 32% (both P < .001).

“Given the long duration of our intervention, the vaccination rates for pneumococcal pneumonia may have been falsely elevated because these numbers reflect cumulative rates. However, the mean numbers of vaccinations administered for both influenza and pneumococcal pneumonia were significantly greater on pilot period days than on nonpilot period days,” the researchers wrote. Other limitations included lack of socioeconomic data and failure to achieve the goal of increasing vaccination rates to 60%, which “highlights the need to acquire a better understanding of the barriers to vaccination.”

“Gastroenterologists should be aware of the increased risk of vaccine preventable illnesses in this patient population and should consider using simple tools and checklists to increase vaccination rates,” Farraye said. – by Adam Leitenberger

Disclosure: The researchers report no relevant financial disclosures.