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Gastroenterologists' knowledge of vaccinations in IBD patients lacking
Wasan SK. Inflamm Bowel Dis. 2011;doi:10.1002/ibd.21667.
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Gastroenterologists’ had poor knowledge of appropriate immunizations for their patients with inflammatory bowel disease. Researchers, therefore, suggest for educational programs to ensure that these patients receive recommended vaccinations.
“Gastroenterologists need to do a better job of recommending the appropriate vaccinations to their inflammatory bowel disease (IBD) patients, as their immunosuppressive medications put them at higher risk for acquiring infections that could be prevented,” Sharmeel K. Wasan, MD, of the gastroenterology section at the Boston Medical Center, told Infectious Disease News. “Simply increasing awareness that gastroenterologists are doing a poor job of vaccinating their IBD patients will serve as a first step in improving the recommendations that they make.”
Wasan and colleagues assessed the knowledge of recommended vaccinations in patients with IBD among 108 randomly selected gastroenterologists from the American College of Gastroenterology. Participants were asked to complete an electronic survey that included questions about the suitable vaccinations for the immunocompetent and immunosuppressed patient with IBD; barriers to vaccine recommendations; and the perceived role of the gastroenterologist vs. the primary care physician.
Forty gastroenterologists reported management of fewer than 40 patients with IBD and 68 reported management of more than 40 patients with IBD. Overall, 52% of those surveyed said they requested immunization history from their patients either all or most of the time.
Compared with 67.5% of academic physicians who were more likely to inquire about immunization history most or all of the time, only 42.4% of private practice physicians inquired about immunization history (P=.01). Fifteen percent of gastroenterologists said they did not regularly recommend influenza immunization because they were too busy or forgot; had no specific reason; or they did not know the patient needed vaccination.
Further, 64% said the PCP was responsible for determining which vaccinations to administer, and 83% said the PCP was responsible for administering the vaccine.
Only 66% of gastroenterologists reported recommending the human papillomavirus vaccine to immunocompetent patients with IBD, and only 47% recommended the vaccine to immunosuppressed patients.
“Gastroenterologists who care for IBD patients are the most qualified clinician to anticipate future need for immunosuppressive therapy (even if none are being prescribed presently), and consider the capacity for an appropriate serologic response to vaccination,” the researchers wrote. “We do not imply that the gastroenterologist needs to administer vaccinations, but rather they need to make explicit recommendations to the PCP regarding the needed vaccinations.”
Disclosure: Dr. Wasan reports no relevant financial disclosures.
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