Sheikh Saira Z, Iglesia Edward G A, Underwood Matthew, Saxena-Beem Shruti, Kwan Mildred
University of North Carolina Thurston Arthritis Research Center, Chapel Hill, North Carolina, USA.
Department of Medicine, Division of Rheumatology, Allergy and Immunology, University of North Carolina at Chapel Hill, North Carolina, USA.
Lupus (Los Angel). 2019;4(2). doi: 10.35248/2684-1630.19.4.146. Epub 2019 Nov 29.
Annual influenza and pneumococcal vaccination rates remain suboptimal in patients with systemic lupus erythematosus despite their higher risk of infections and related complications. The CDC identified lack of knowledge about vaccine guidelines among adult patients and their providers as the most substantial barrier to vaccination coverage. As specialists working with particularly affected populations, rheumatologists, allergists, and immunologists can advise patients regarding gaps in recommended vaccinations.The aim of this study was to describe prescribers' perceptions of an educational activity that was developed to increase rates of appropriate pneumococcal and influenza vaccination in adults with chronic inflammatory conditions. We were interested in the impact of the educational activity on the knowledge and practice of providers.
We evaluated a multimodal educational activity aimed at increasing vaccination rates in high-risk adults. We assessed provider knowledge, perceptions of the activity, and impact on their practice. The activity was conducted at a single site "in house" education event in the live format and was disseminated nationally in print and online format.
In the "in house" interactive education session, mean scores on the pre- and post-tests were 75% (SD 11.6%, 95% CI 70-80%) and 89% (SD 11.1%, 95% CI 85-95%; p=.0001 vs. pre-test score), respectively, demonstrating that knowledge was significantly increased after completing the activity. In the nationally available activity 93% (n=240) of respondents indicated that the activity significantly increased their awareness about the importance of vaccinations in these high-risk patients and recognition of when these vaccines were indicated or contraindicated, while 55% (n=142) planned to consequently change their practice.
Provider education is a valuable strategy for practice-based improvements in vaccination coverage since provider failure to recommend vaccinations is a primary barrier in high-risk patients. Most patients received vaccinations based on physician recommendations and vaccination rates were markedly higher among patients receiving vaccine information from their providers. This educational activity increased clinicians' knowledge of and confidence in vaccinations for adults with chronic inflammatory conditions.
尽管系统性红斑狼疮患者感染及相关并发症风险较高，但年度流感和肺炎球菌疫苗接种率仍未达到最佳水平。美国疾病控制与预防中心认定，成年患者及其医疗服务提供者对疫苗指南缺乏了解是疫苗接种覆盖率面临的最主要障碍。作为诊治特定受影响人群的专科医生，风湿病学家、过敏症专科医生和免疫学家可为患者提供有关推荐疫苗接种方面的差距的建议。本研究的目的是描述开处方者对一项教育活动的看法，该活动旨在提高患有慢性炎症性疾病的成年人适当接种肺炎球菌和流感疫苗的比例。我们关注该教育活动对医疗服务提供者的知识和实践的影响。
我们评估了一项旨在提高高危成年人疫苗接种率的多模式教育活动。我们评估了医疗服务提供者的知识、对该活动的看法以及对其实践的影响。该活动以现场形式在一个地点举办了“内部”教育活动，并以印刷品和在线形式在全国范围内传播。
在“内部”互动教育环节中，测试前和测试后的平均得分分别为75%（标准差11.6%，95%置信区间70 - 80%）和89%（标准差11.1%，95%置信区间85 - 95%；与测试前得分相比，p = 0.0001），表明完成活动后知识显著增加。在全国范围内开展的活动中，93%（n = 240）的受访者表示该活动显著提高了他们对这些高危患者接种疫苗重要性的认识，以及对何时应接种或禁忌接种这些疫苗的认识，而55%（n = 142）的受访者计划因此改变他们的做法。
由于医疗服务提供者未能推荐接种疫苗是高危患者的主要障碍，因此对医疗服务提供者进行教育是基于实践提高疫苗接种覆盖率的一项有价值的策略。大多数患者根据医生的建议接种疫苗，从医疗服务提供者处获得疫苗信息的患者的接种率明显更高。这项教育活动增加了临床医生对患有慢性炎症性疾病的成年人接种疫苗的知识和信心。
