55 Influenza vaccine uptake in a cardiology outpatient department setting; a missed cardiovascular disease prevention opportunity

Abstract

Aim Management of chronic illness is a cornerstone of care in the secondary care setting. Cardiovascular patients may have multiple indications for influenza vaccination and protection from Flu may improve both mortality and morbidity. Studies have shown a direct link between inflammation, respiratory illness and acute myocardial infarction and there is existing evidence that influenza vaccination reduces acute MI rates in both primary and secondary prevention. The aim of this audit was to evaluate if patients attending a cardiology outpatient department, with an indication for influenza vaccination, as per current guidelines, are adequately vaccinated and if an opportunity lies there in to target this patient cohort and improve outcomes. Method Patients attending two large university teaching hospital outpatient departments were asked to fill out a survey, including simple personal medical history details, seeking to identify; patients with an indication for vaccination, patients that had been offered vaccination and reasons for refusal if they had been offered but declined. Unvaccinated patients were asked if would they avail of vaccination if it were available on the day at the clinic. The results were collated and reviewed. Results 142 respondents in total; average age 66.2 yrs (STD 14.2), 64.7% male, 79.6% >50 yrs, 28.9% attended a Heart Failure Unit, 81.7% overall had an indication for vaccination other than age alone and 90.8% had an indication when age >50 yrs was also included. Of the patients with an indication for vaccination, vaccination rates were; 62.9% males, 60.0% females, 73.2% Heart Failure clinic attendees, 56.8% General Cardiology attendees (p=0.075 for difference in vaccination rates among clinic types). Of the patients with an indication for vaccination that had not been vaccinated thus far, 48.9% would have received the vaccine on the day if offered. This would have improved the overall vaccination rate amongst patients with an indication for vaccination from 62.0% to 80.6% (p=0.015). Of the patients who would not opt to receive the vaccine if offered, 23% believe it doesn’t work, 23% believe they would contract influenza from it and 38.5% have plans to receive the vaccine elsewhere.