Consultation improves vaccination rates for patients with IBD, GI cancers
A single visit with a consultant helped improve vaccination knowledge and coverage among patients with inflammatory bowel disease or gastrointestinal cancers, according to research published in Alimentary Pharmacology & Therapeutics.
Anthony Lopez, MD, of the department of gastroenterology and hepatology at the University Hospital of Nancy, in France, and colleagues wrote that vaccinations for influenza and pneumococcus are low in the IBD and GI cancer populations even though both groups are considered high-risk.
“Lack of awareness, the incorrect assumption that all vaccines cannot be safely administered to IBD patients, fear of side effects, and ambiguity in whether the primary care physician or gastroenterologist should assume responsibility for administering the vaccinations are some of the more common reasons for explaining the lack of immunization,” they wrote.
To test the impact of a specialized infectious disease consultation, researchers analyzed data from 366 patients from the Nancy hospital’s gastroenterology department with either IBD (n = 267) or GI cancer (n = 99). They enrolled the patients into a three-phase vaccination program. Phase one was an initial questionnaire that assessed each patient’s vaccination status, as well as their knowledge about vaccines and potential barriers to vaccination. Phase two was the infectious disease consultation, and phase three was another questionnaire about the evolution of their vaccination knowledge.
Vaccination rates for the overall group were 34.7% for influenza and 14.5% for pneumococcus, with about 43% of patients reporting that they feared the side effects of vaccines.
After the first questionnaire, 102 patients participated in the consultation. Investigators found that 89 of these patients (87.3%) received a vaccination after the consultation, while 41.2% reported that they had changed their minds about vaccination, and 92.2% said they would recommend the program to others.
In patients with GI cancers, the pneumococcal vaccination rate increased from 10.1% before consultation to 87.5% after. In patients with IBD, the rate increased from 16.1% to 85.7%.
Lopez and colleagues wrote that this program could be expanded to include other high-risk populations to lower the morbidity, mortality and costs associated with infectious diseases.
“A specialized health care provider in the infectious disease unit may significantly improve the vaccination rate in patients with IBD and [GI cancers] with only one consultation,” they wrote. “This simple method could be applied globally to improve vaccination coverage in such patients, as long as we can develop enough consultation facilities.” – by Alex Young
Disclosures: Lopez reports serving as an advisory board member for Amgen and as a speaker for Vifor Pharma. He also received research funding from Roche. Please see the full study for all other authors’ relevant financial disclosures.