Andrew Canakis, DO, on Improving Vaccination Rates in IBD
Research has shown that individuals with inflammatory bowel disease (IBD) do not receive appropriate vaccinations at the same rate as the general population.
Results from a randomized study presented at Digestive Disease Week 2019 showed biweekly reminders from an electronic health record (EHR) patient portal can improve vaccination rates for both pneumococcal and influenza vaccines among individuals with IBD.
Gastroenterology Consultant caught up with Andrew Canakis, DO, a resident physician at Boston Medical Center, about the research.
Gastroenterology Consultant: What prompted you to conduct the study?
Andrew Canakis: In our IBD subspecialty practice at Boston Medical Center, a large percentage of patients communicate with their provider via MyChart, a patient portal embedded within the EHR. We wanted to determine if the portal could serve as a method to send automated messages to patients regarding their vaccinations. Therefore, we enrolled 127 adults with IBD between November 2017 and March 2018. We randomly assigned participants to receive either specific disease-related information or biweekly messages unrelated to IBD (the control group). An in-office questionnaire was administered to measure vaccine uptake.
GASTRO CON: What do you think is the most important finding?
AC: For the 2017-2018 influenza season, prior to intervention, 84% of participants in the control group and 68% in the intervention group reported receiving the influenza vaccination. At 6-month follow-up, the influenza vaccination rate increased to 85% in the intervention group; the vaccination rate was 86% in the control group. For pneumococcal vaccinations, 78% of the control group and 74% of the intervention group reported receiving the vaccination prior to the intervention. At 6-month follow-up, the pneumococcal vaccination rate increased to 94% in the intervention group and 89% in the control group. Our data suggest that patient portals can be used as a tool to increase vaccination rates in patients with IBD. The increase in the vaccination rate for pneumococcal pneumonia is particularly significant. Additionally, the use of a portal like this could be effective in increasing other important health maintenance tests such as cancer screening in the future.
GASTRO CON: How can a gastroenterologist or specialist apply these findings to clinical practice?
AC: Providers should check with their IT staff to see if their EHR system has the capability of sending automated messages to patients. If this option is not available, clinicians can also consider using social media to send important health-related messages to their patients. A simple reminder sent to a patient through their portal can have long-lasting benefits, especially when it comes to vaccinations. We also feel that the EHR allows patients to benefit from an ongoing provider relationship between regular office visits.
GASTRO CON: What are the next steps of your research?
AC: Moving forward, we would like to see if patient portals can be utilized to improve other areas of preventive care among patients with IBD. For instance, reminders could benefit patients on long-term steroid therapy who need to be reminded about the importance of obtaining a bone density test.
Reference:
Canakis A, Reich J, Shankar D, et al. Increasing vaccination rates with a patient portal (MyChart-Epic) in patients with inflammatory bowel disease: results of a randomized clinical trial [abstract 111]. Presented at: Digestive Disease Week; May 18-21; San Diego, CA. https://www.gastrojournal.org/article/S0016-5085(19)36845-3/pdf. Accessed June 6, 2019.