AB1234\u2005OUTCOME OF EDUCATION WITH REGARD TO INFLUENZA AND PNEUMOCCOCAL VACCINATIONS IN INFLAMMATORY ARTHRITIS PATIENTS ON DMARDS

Abstract

Background: Inflammatory arthritis (IA) patients on immunosuppressant disease modifying drugs (DMARDs) are at an increased risk of infections. Influenza and pneumococcal vaccines are recommended as part of the BSR and EULAR guidelines for the clinical management of these patients. Prior to commencing DMARDS, the patients are reviewed by the nurse specialist, who discusses the benefits versus risks of DMARDS, necessary monitoring and recommends the pneumococcal and influenza vaccines. Objectives: The aim of this audit is to assess the uptake of the pneumococcal and the influenza vaccine in IA patients prior to starting biologic or synthetic DMARDs as advised by the nurse specialist during the education visit with the patient. Methods: The study sample included 139 patients with various types of IA, including rheumatoid arthritis, psoriatic arthritis and ankylosing spondylitis, who attended the rheumatology nurse education sessions prior to starting DMARDs in a secondary care hospital in 2017. Verbal advice supported by a vaccination leaflet developed in 2016 was given by the rheumatology nurse. Data was compiled by means of a telephone questionnaire. Results: One hundred and twenty six (90.6%) participants recalled being given advice on vaccinations. Seventy eight (62%) of these patients received the influenza vaccine. The rest (28%) did not receive the vaccine for various reasons including fear of side effects, fear of developing a worse infection, belief of inefficacy and fear of injections. A significant improvement (p=0.0084) in the influenza vaccination rates was noted since a previous audit in 2016, where following verbal education by a rheumatologist, only 41.4% received the influenza vaccine. A significant improvement in uptake was also noted in the pneumococcal vaccination rates since only 17.2% of the patients received the pneumococcal vaccine in 2016 compared to 62.7% in 2017 (p<0.0001). Various reasons including fear of side effects, belief of inefficacy, fear of injections and financial implications were given by patients who did not receive the pneumococcal vaccine. Overall, 62% of the patients received both vaccines after education given by the rheumatology specialist nurse and receiving the vaccination leaflet. Conclusion: This audit showed a significant progress in the uptake of the influenza and pneumococcal vaccinations in patients with inflammatory arthritis following verbal advice by the specialist rheumatology nurse and the introduction of a vaccinations’ educational leaflet. Disclosure of Interests: None declared