Gastroenterologists lack critical knowledge of vaccination for IBD patients
MedWire News: Study findings show gastroenterologists have limited knowledge of the correct vaccinations for patients with inflammatory bowel disease (IBD), with the majority believing that the primary care provider (PCP) should be responsible for such vaccinations.
"Despite an increased risk for infections on [immunosuppressive agents], many IBD patients are not being appropriately vaccinated. Barriers to vaccination described by patients include a lack of awareness and concern for side effects, suggesting that providers are not adequately educating and recommending vaccinations to their immunosuppressed patients," said study co-author Francis Farraye (Boston University, Massachusetts, USA).
The researchers, led by Sharmeel Wasan (Boston University) administered a 19-question electronic questionnaire regarding suitable vaccines for immunosuppressed IBD patients, barriers to recommending these vaccines, and the role of the gastroenterologist versus the PCP in recommending and administering vaccines to 1000 gastroenterologists who were members of the American College of Gastroenterology.
Analysis of the 108 returned surveys showed that only 52% of gastroenterologists took an immunization history for their patients most or all of the time. This finding did not significantly change according to practice size (less than 40 IBD patients vs more than 40 IBD patients).
However, physicians working within academia were significantly more likely to obtain a full immunization history compared with private physicians, at 67.5% versus 42.4%.
Overall, 64% of gastroenterologists believed the PCP was responsible for determining which vaccinations were necessary, with 83% reporting that the PCP should be responsible for administering vaccines.
The team also found that 66-88% of gastroenterologists correctly recommended the inactivated vaccines for IBD patients not on immunosuppressive therapies, while 20-30% incorrectly recommended administering the live vaccines to immunosuppressed patients.
Knowledge of the human papillomavirus vaccine was found to be particularly low, with only 66% and 47% of physicians recommending the vaccine to immune-competent and immunosuppressed patients, respectively.
Furthermore, 16 of the 108 surveyed gastroenterologists did not regularly recommend immunization against influenza, with the most commonly cited reasons including "too busy/forgot," "no specific reason," and "did not know my patient needed it."
Writing in the journal Inflammatory Bowel Diseases, the researchers conclude: "The results of our survey… highlight the glaring inadequacy of gastroenterologists' approach to the vaccination of their IBD patients and demonstrates that intensive educational efforts are required to ensure that patients receive the vaccinations they need and that immunosuppressed patients do not receive vaccines that might put them at risk of infection."
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By Ingrid Grasmo