Health Maintenance and Vaccination of Patients With Inflammatory Bowel Disease: Practice and Perception of Responsibility of Gastroenterologists vs Primary Care Providers

Hammami, Muhammad B.; Pandit, Pratik; Salamo, Rebecca T.; Odufalu, Florence-Damilola; Schroeder, Katie

doi:10.31486/toj.18.0086

Cited by 10 publications

(8 citation statements)

References 24 publications

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“…3,36,37 Factors contributing to low vaccination rates include a lack of perceived susceptibility to influenza, lack of perceived severity of infection and lack of belief in the vaccine's effectiveness. 2,3,[47][48][49] Interventions to improve vaccination rates in populations of persons with immune-mediated disease have been tested. Use of electronic medical record alerts improved vaccination rates in immunosuppressed people seen in rheumatology clinics (outpatient, hospital-based); having a nurseled process improved vaccination rates further.…”

Section: Discussionmentioning

confidence: 99%

Uptake of influenza vaccination among persons with inflammatory bowel disease, multiple sclerosis or rheumatoid arthritis: a population-based matched cohort study

Marrie

Walld

Bolton

et al. 2021

cmajo

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I ndividuals affected by immune-mediated inflammatory diseases (referred to hereafter as immune-mediated diseases), such as inflammatory bowel disease, multiple sclerosis and rheumatoid arthritis, share an increased risk for influenza and related complications; 1 therefore, prevention of influenza is important. Effective implementation of influenza vaccination strategies requires knowledge of vaccine uptake or use among target populations. However, our understanding of influenza vaccine uptake in populations with immune-mediated diseases has been limited by studies with small sample sizes, selection bias, cross-sectional designs, variable study durations and variable study periods. Prior findings regarding vaccine uptake among persons with immune-mediated diseases have been highly variable. 2-5 A

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Section: Discussionmentioning

confidence: 99%

Uptake of influenza vaccination among persons with inflammatory bowel disease, multiple sclerosis or rheumatoid arthritis: a population-based matched cohort study

Marrie

Walld

Bolton

et al. 2021

cmajo

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“…Participants reported whether their neurologist had ever asked about their immunization/vaccination history (yes, no, or don't know) and who they thought was responsible for determining which vaccinations they should receive (neurologist, primary care physician, participant, and other; multiple options were allowed). 14 Participants were asked to report whether they had ever received vaccines for any of the following: hepatitis A, hepatitis B, pneumococcal, shingles, varicella, measles/mumps/rubella, and tetanus, where responses were yes, no, or don't know. For all vaccines except influenza, the time frame was ever receipt of the vaccine.…”

Section: Methodsmentioning

confidence: 99%

Uptake and Attitudes About Immunizations in People With Multiple Sclerosis

et al. 2021

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Objective:By surveying a multiple sclerosis (MS) population, we tested the hypothesis that influenza vaccine uptake would not meet public health targets in a large multiple and that vaccine misconceptions would contribute to lower than desired uptake.Methods:In Spring 2020, we surveyed participants in the North American Research Committee on Multiple Sclerosis (NARCOMS) Registry regarding vaccinations. Participants reported whether they had received hepatitis A, hepatitis B, pneumococcal, shingles, varicella, measles/mumps/rubella, tetanus or influenza vaccines. Participants who had not received influenza vaccine last year reported why not. We summarized responses descriptively. Using multivariable logistic regression, we assessed participant characteristics associated with uptake of seasonal influenza vaccine.Results:Of 5,244 eligible respondents, 80.8% were female, with a mean (SD) age of 61.8 (10.1) years. Overall, 43.0% (2161/5032) of participants reported that their neurologist had ever asked about their immunization history. The percentage of participants who received the seasonal flu vaccine last year ranged from 59.1% among those aged 18-24 to 79.9% for persons aged ≥65 years. Among those who did not get the influenza vaccination those most common reasons were personal preference (29.6%), concerns about possible adverse effects in general (29.3%), and concerns that the vaccine would worsen their MS (23.7%).Conclusion:Vaccination uptake is lower than desired in the MS population as compared to existing recommendations, including for seasonal influenza. Misconceptions about the safety of vaccination in the context of MS and personal preference appear to play important roles in vaccination choices, highlighting the importance of education about these issues.

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“…Immunosuppressed IBD patients had a lower rate of being vaccinated for TDaP and a higher rate of being vaccinated for pneumococcus. A reason for why this effect was seen may be because TDaP is more likely to be given to patients by their PCP, rather than their GI provider [7]. PCP's are also less likely to immunize patients on immunosuppression, possibly explaining the negative effect immunosuppressive therapy had on TDaP [22].…”

Section: Discussionmentioning

confidence: 99%

“…This close relationship may lead to patients treating their GI provider as their PCP, leading to confusion over whose responsibility it is to vaccinate IBD patients [6]. There is data that shows that many GI providers are less likely to vaccinate patients than PCPs and are less aware of the appropriate immunizations for IBD patients [7][8][9]. As a result, IBD patients often miss opportunities to receive necessary vaccines [10].…”

Section: Introductionmentioning

confidence: 99%

Type of GI Provider Does Not Affect Rates of Vaccination Amongst Inflammatory Bowel Disease Patients

Trivedi

Malik

Kwah

2021

Preprint

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Background:Patients with Inflammatory Bowel Disease (IBD) are at heightened risk of infection, and are often under vaccinated. At our institution, IBD patients may follow up with one of three gastroenterology (GI) providers: IBD specialists, GI Fellows and General GI providers. Aims: Our primary objective was to identify whether the type of GI provider had an effect on rates of vaccinations for IBD patients. The seven vaccines studied were listed in the American College of Gastroenterology’s 2017 Guidelines on Preventative Care in IBD, and include Influenza, Tetanus/Diphtheria/Pertussis, Hepatitis A (HAV), Hepatitis B (HBV), Pneumococcus (PCV13 and PPSV23), Meningococcus, and Human Papillomavirus (HPV).Methods:Retrospective case control study of IBD patients, looking at vaccination rates for each of the seven vaccinations listed above, and type of GI provider followed. Other data collected included patient demographics, IBD type, treatment regimen and insurance.Results:Of 338 IBD patients, 65 (19.2%) followed up with a GI fellow, 110 (32.5%) with a general GI provider, and 163 (48.2%) with an IBD specialist. HBV was the only vaccine with a significant difference in vaccination rate by type of provider. Bivariate analysis showed that patients who followed with IBD specialists and GI fellows were more likely to be vaccinated for HBV than patients who followed up with general GI provider (OR = 2.55, p = .003 and OR = 2.73, p = .007 respectively).Conclusion Type of GI provider only impacted rates of vaccination for HBV among IBD patients in this study, with IBD specialists and GI fellows outperforming general GI providers.

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Health Maintenance and Vaccination of Patients With Inflammatory Bowel Disease: Practice and Perception of Responsibility of Gastroenterologists vs Primary Care Providers

Cited by 10 publications

References 24 publications

Uptake of influenza vaccination among persons with inflammatory bowel disease, multiple sclerosis or rheumatoid arthritis: a population-based matched cohort study

Uptake of influenza vaccination among persons with inflammatory bowel disease, multiple sclerosis or rheumatoid arthritis: a population-based matched cohort study

Uptake and Attitudes About Immunizations in People With Multiple Sclerosis

Type of GI Provider Does Not Affect Rates of Vaccination Amongst Inflammatory Bowel Disease Patients

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