199. A RE-AUDIT OF INFLUENZA AND PNEUMOCOCCAL VACCINATION IN PATIENTS ATTENDING RHEUMATOLOGY CLINICS

Abstract

Background: An audit was undertaken in March 2014 looking at pneumococcal and flu vaccination in patients attending rheumatology clinics at University Hospital of Wales (UHW), Cardiff. The aim was to assess adherence to the Public Health Wales vaccination guidelines which recommend Influenza and Pneumococcal vaccination in patients above the age of 65 years and in patients with suppressed immune system. The Welsh average uptake rate for vaccination in atrisk patients under 65 years of age was 49.3% in 2015 and the Welsh government target for annual flu vaccination uptake is 75%. We have re-audited our practice to assess improvement in the areas highlighted in that audit. Method(s): Data were prospectively collected during March 2016 from patients attending rheumatology clinics at UHW using standard audit pro forma. The findings were compared to the standards set in the above mentioned guidelines and to the results from the previous audit. The following information was recorded: Patient's diagnosis and their medication. Dates of receiving pneumococcal and influenza vaccination. Patient's awareness regarding the need for vaccination. The place where vaccination was administered. Result(s): Data were collected from 100 patients (75 female and 25 male). Mean age was 59.8 years. 44% patients were above the age of 65 years. Majority of the patients (63%) had a diagnosis of rheumatoid arthritis followed by Polymyalgia rheumatic/Giant cell arteritis (12%), Ankylosing spondylitis (4%) and Systemic Lupus erythematosus (4%). Majority of patients (34%) were taking Methotrexate followed by prednisolone (30%), hydroxychloroquine (23%) and sulfasalazine (15%). 32% patients were on biologic agents. Overall 78% patients received influenza vaccination and 40% received pneumonia vaccination compared to 79% and 37% patients respectively in 2014. Vaccination uptake in above 65 years old patients was 86% for flu and 55% for pneumococcal vaccination compared to 81% and 40% in the initial audit. 98% patients received their vaccination in primary care. 87% patients (71% in 2014) were aware of the need for vaccination of which 57% patients were made aware by their GPs and 33% by rheumatology clinicians. 6% patients declined vaccination. Conclusion(s): This re-audit has shown an improvement in patient awareness regarding the need for vaccination. Although the vaccination uptake for influenza vaccination is similar to the previous audit, it exceeds the Welsh national uptake target of 75% and is higher than the national average uptake rate. Two-thirds of patients received their vaccination at their GP surgeries. We need to routinely ask patients about their vaccination in clinic and recommend vaccination to at-risk patients. In order to improve the vaccination uptake further, we need to raise awareness amongst patients and professionals including GPs and hospital doctors from different specialties.