Can a Single Live Didactic Lecture Modify Gastroenterologists Vaccination Practices for Patients with Inflammatory Bowel Disease?

Abstract

Purpose: Barriers to vaccination in inflammatory bowel disease (IBD) patients include limited gastroenterologists knowledge of the appropriate immunizations to recommend. As such, many IBD patients are not being appropriately vaccinated. Our study aimed to assess the impact of a single live didactic educational lecture on provider knowledge on vaccinating IBD patients. Methods: We developed a 16 question cross-sectional survey that was administered to gastroenterologists, NPs and PAs (health care providers [HCPs]) who attended the “What's New in Pharmacology” course at the American College of Gastroenterology annual meeting in October 2011. We compared aggregate responses to the survey both before and immediately after the lecture entitled “A Gastroenterologist's Guide to Vaccinating Your Patient on Steroids, Immunomodulators or Biologic Agents”. Results: Of 619 attendees, 219 HCPs filled out the survey pre-lecture and 84 HCPs completed the post lecture survey. Pre-lecture, 75-80% of HCPs correctly reported that the live vaccines (varicella, herpes zoster, and MMR (measles, mumps, rubella) were not suitable for their patients on immunosuppressive therapy. Post-lecture, more HCPs (90%) correctly stated that they would not administer the varicella and MMR vaccines in their immunosuppressed patients (p<0.05). For the immunocompetent patient, HCPs were more likely to appropriately recommend the hepatitis B, HPV, MMR and varicella vaccines post lecture (p<0.05). Overall, there was a trend towards an increased number of HCPs correctly determining all of the indicated vaccinations for the IBD patient post lecture. After attending the lecture, there was a trend for HCPs to state that they would ask their IBD patients about their vaccination history (44.5% pre, 55.2% post, p=0.15). About 60% of HCPs thought that the gastroenterologist was responsible for determining the vaccines to give to the IBD patient, both before and after the lecture. However, the majority of HCPs surveyed (80%) continued to think that the primary care physician (PCP) should be responsible for administering vaccinations. Conclusion: Educational programs, such as live didactic lectures directed to Gastroenterology HCPs who prescribe immunosuppressive agents can have a clinically significant impact on knowledge of the appropriate immunizations indicated in IBD patients. However, despite an increased knowledge base, gastroenterologists continue to rely on the PCP to administer vaccinations suggesting that education and communication with both the patient and the PCP is necessary if increased vaccination rates are to be attained.