Introduction Over the past decade, there has been an increasing uptake of immunomodulator therapy in the treatment of Inflammatory Bowel Disease (IBD). The current British Society of Gastroenterology (BSG) and European Crohn’s and Colitis Organisation (ECCO) guidelines highlight the importance of influenza, pneumococcal, human papilloma virus, varicella and hepatitis B vaccination. Our previous audit in 2014 described 75% uptake of any vaccination in these patients. Here we present the re-audit after an intervention, where a letter was sent to general practitioners (GPs) to promote immunisation awareness.
Methods 100 consecutive IBD patients attending the general gastroenterology outpatient clinic were asked to complete a questionnaire. All forms of IBD were included. Information regarding medication, infections and immunisation status were recorded. Results were analysed using the statistical package for the social sciences (SPSS).
Results Of the 100 questionnaires returned, 3 were excluded due to incomplete completion. Median age was 46 (19–84). Of the IBD subtypes, 48 (49%) patients had Crohn’s, 34 (35%) had ulcerative colitis and 15 (16%) had colitis of unknown aetiology (CUTE); male to female ration was 48:52%. 92% of patients with IBD had medication prescribed in the past 6 months. Within this group, 59% had been on mesalazine, 38% on thiopurines, 36% on steroids and 12% on anti tumour necrosis factor (anti-TNF) agents. Overall, 68% of immunosuppressed patients received some form of immunisation in the preceding 6 months and, of these, 28% had some form of infection reported. In total, 44% of patients had immunosuppressant advice given and 29% of patients had vaccination advice. There was no statistical difference in the baseline characteristics of patients and prescribed medication compared to 2014. Despite engagement with primary care, there was no significant difference in the uptake of immunisation in the IBD population. In fact, there were statistically lower rates of Influenza and Pneumovax vaccination in the 2015 cohort (P < 0.05). The only statistical improvement was in HPV vaccination (adjusted) (see table).
Conclusion Current guidelines state that influenza, pneumococcal and HPV vaccination be considered for all IBD patients. Despite the results of our previous audit there does not appear to be an improvement in vaccination rates. A weakness in the current approach is that information is received by GPs at differing intervals to when a patient is seen. It may be that a targeted, patient-specific letter is sent to GPs with an attached acknowledgement receipt to improve vaccination rates.
Disclosure of Interest None Declared
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