在电子病历中使用疫苗接种工具对免疫介导的炎症性疾病患者疫苗接种覆盖率的影响:一项前瞻性队列研究。

Infectious diseases (London, England) Pub Date : 2024-10-01 Epub Date: 2024-06-07 DOI:10.1080/23744235.2024.2361795
Liselotte Fierens, Sofie Coenen, Johan Joly, Tine Vanhoutvin, Els De Dycker, Delphine Bertrand, Eva Van Laer, Jens Penny, Jan Reumers, Patrick Verschueren, Petra De Haes, Paul De Munter, Marc Ferrante
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引用次数: 0

摘要

背景:免疫介导的炎症性疾病(IMID)发病率不断上升,需要创新的管理策略,包括有效的疫苗接种。我们旨在评估电子病历(EMR)集成疫苗接种工具对炎症性肠病(IBD)、风湿病和皮肤病患者疫苗接种覆盖率的影响:一项前瞻性观察研究比较了模块实施前(2018 年)和实施后(2021 年)的疫苗接种覆盖率。研究收集了 1430 名 IMID 患者(44.9% 为男性,中位年龄(四分位距[IQR])54(40-66)岁,789 名 IBD 患者、604 名风湿病患者和 37 名皮肤病患者)的流感、肺炎球菌、乙型肝炎和破伤风疫苗接种数据以及潜在预测因素。采用 McNemar 检验、卡方检验和多项式逻辑回归对数据进行了分析:肺炎球菌接种率显著上升(从 56.6% 上升至 73.1%,p = 0.006),但总体保持稳定(从 73.1% 上升至 73.2%,p = 1.000)。破伤风疫苗接种率有所下降(50 岁和/或接受免疫抑制治疗的患者从 71.5% 降至 55.0%,年龄大于 65 岁和/或接受免疫抑制治疗的患者在过去 5 年中接种过肺炎球菌疫苗,IBD 患者接种过乙型肝炎疫苗),从 41.3% 上升至 54.8%(p 结论):实施疫苗接种工具后,疫苗接种覆盖率有所提高。COVID19 大流行和 2018 年的测量可能提高了疫苗接种意识。对患者和医疗保健专业人员的教育仍然至关重要。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Effects of implementing a vaccination tool in the electronic medical record on vaccination coverage of patients with immune-mediated inflammatory diseases: a prospective cohort study.

Background: The rising incidence of immune-mediated inflammatory diseases (IMID) requires innovative management strategies, including effective vaccination. We aimed to assess the impact of an electronic medical record (EMR)-integrated vaccination tool on vaccination coverage among patients with inflammatory bowel diseases (IBD), rheumatological and dermatological conditions.

Methods: A prospective observational study compared vaccination coverage before (2018) and after (2021) implementing the module. Vaccination data for influenza, pneumococcus, hepatitis B and tetanus, and potential predictors were collected from 1430 IMID patients (44.9% male, median age (interquartile range [IQR]) 54 (40-66) years, 789 with IBD, 604 with rheumatological and 37 with dermatological conditions). Data were analysed using McNemar, chi-square tests and multinominal logistic regression.

Results: Significant increases in pneumococcus (56.6% to 73.1%, p < .001) and hepatitis B vaccination (62.2% to 75.9%, p < .001) were observed. Influenza vaccination rates increased among IBD (76.2% to 80.5%, p = .006) but remained stable overall (73.1% to 73.2%, p = 1.000). Tetanus vaccination rates decreased (71.5% to 55.0%, p < .001). The proportion of fully vaccinated patients (against influenza in the past year for patients >50 years old and/or under immunosuppressive therapy, against pneumococcus in the past 5 years for patients >65 years old and/or under immunosuppressive therapy and additionally against hepatitis B for IBD patients) rose from 41.3% to 54.8% (p < .001 all using McNemar). Factors associated with vaccinations included age, immunosuppressive therapy and education level.

Conclusions: Increased vaccination coverage was measured after implementing the vaccination tool. The COVID19 pandemic and the 2018 measurement might have increased vaccination awareness. Education of patients and healthcare professionals remains crucial.

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