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Implementing guidelines on the prevention of opportunistic infections in inflammatory bowel disease.
- Source :
-
Journal of Crohn's & colitis [J Crohns Colitis] 2013 Nov; Vol. 7 (10), pp. e449-56. Date of Electronic Publication: 2013 Apr 17. - Publication Year :
- 2013
-
Abstract
- Introduction: Opportunistic infections are a key safety concern in the management of patients with inflammatory bowel disease (IBD). Despite the existence of international guidelines, many gastroenterologists have not adopted routine screening and vaccination. The aim of this study was to modify clinical behaviour by use of a simple screening tool.<br />Methods: A screening and vaccination proforma for hepatitis B, varicella, Influenza, Pneumococcus, human papillomavirus, tuberculosis, hepatitis C and HIV was provided to each participating gastroenterologist. Gastroenterologists were surveyed for awareness of vaccine recommendations and current practice prior to and following the introduction of the proforma. Rates of immunity and the proportion of patients receiving the recommended screening and vaccinations were documented.<br />Results: 30 gastroenterologists at 8 different IBD centres took part in the assessment. A total of 919 patients were included (55% female, 65% Crohn's, 33% ulcerative colitis, 2% indeterminate IBD). Introduction of the proforma increased self-reported gastroenterologist screening from 47% to 97% pre- and post-intervention respectively, p<0.001. After the proforma was applied, vaccination against hepatitis B, varicella, Influenza, and Pneumococcus was recommended in 67%, 2.5%, 75% and 69% of the patients respectively. Of these, 42%, 39%, 66% and 49% patients followed the recommendations and were vaccinated. Cervical smears were recommended in 31%, with 62% of these obtaining the recommended cervical smear.<br />Conclusions: Implementation of a screening and vaccination proforma significantly changed gastroenterologist self-reported behaviour. Patient compliance with these recommendations was not optimal and suggests the need for further patient education, in addition to other forms of support.<br /> (Crown Copyright © 2013. Published by Elsevier B.V. All rights reserved.)
- Subjects :
- Adult
Chickenpox prevention & control
Female
Gastroenterology standards
Guideline Adherence
HIV Infections diagnosis
Health Knowledge, Attitudes, Practice
Hepatitis B prevention & control
Hepatitis C prevention & control
Humans
Inflammatory Bowel Diseases complications
Influenza, Human prevention & control
Male
Middle Aged
Opportunistic Infections chemically induced
Opportunistic Infections diagnosis
Papillomavirus Infections diagnosis
Papillomavirus Infections prevention & control
Patient Compliance
Pneumococcal Infections prevention & control
Practice Patterns, Physicians'
Records
Self Report
Tuberculosis diagnosis
Immunosuppressive Agents adverse effects
Inflammatory Bowel Diseases drug therapy
Mass Screening standards
Opportunistic Infections prevention & control
Practice Guidelines as Topic
Vaccination standards
Subjects
Details
- Language :
- English
- ISSN :
- 1876-4479
- Volume :
- 7
- Issue :
- 10
- Database :
- MEDLINE
- Journal :
- Journal of Crohn's & colitis
- Publication Type :
- Academic Journal
- Accession number :
- 23601754
- Full Text :
- https://doi.org/10.1016/j.crohns.2013.02.019