Routinely collecting clinical data can improve pneumococcal vaccination of rheumatology patients on immunosuppressant drugs
Research Activities, March 2012, No. 379
Patients with rheumatologic conditions, such as arthritis, often receive medications that can compromise their immune systems. As a result, they may be at risk for pneumonia and other infections. Guidelines from the Centers for Disease Control and Prevention recommend that these patients receive the pneumococcal vaccine. However, vaccination rates remain less than optimal. A new study has investigated how rheumatology practices can routinely measure clinical and administrative data to monitor and increase the number of patients receiving this vaccine.
Researchers used these data to identify 2,763 patients receiving care in a rheumatology clinic. All were receiving immunosuppressive medications. From this information, it was determined just how many patients were up-to-date with the pneumococcal vaccine either while they were on these medications or before starting them in the last 12 months.
The majority of patients were white and female. Half of all patients were being treated for rheumatoid arthritis. The most common medication was methotrexate. More than half of all patients (54 percent) were found to be up-to-date with their vaccination. However, only 45 percent of 568 patients who were just prescribed medication had been vaccinated before starting it. Patients who saw younger rheumatologists in practice for 10 years or less had higher vaccination rates (72 percent) compared to those seeing providers in practice for more than 10 years (52 percent). Practices can use this approach to routinely collect data from billing and electronic health records in order to improve pneumococcal vaccination rates in this group, suggest the researchers. Their study was supported in part by the Agency for Healthcare Research and Quality (HS17030).
See "Routinely measuring and reporting pneumococcal vaccination among immunosuppressed rheumatology outpatients: The first step in improving quality," by Sonali P. Desai, M.D., Alexander Turchin, M.D., M.S., Lara E. Szent-Gyorgyi, M.P.A., and others in Rheumatology 50, pp. 366-372, 2011.