Background Patients suffering from autoimmune inflammatory rheumatic diseases (AIIRD) are at increased risk of infections, due to the underlying condition and its treatment. A study on vaccination in AIIRD carried out at Mater Dei Hospital, Malta in 2015, showed that 37.9% of the patients received the influenza vaccine in the previous year and 8.3% had received the pneumococcal vaccine ever. Only 38.3% knew that they had an increased risk of infection because of their condition.
Objectives The aim of the current study was to establish whether verbal education on vaccination, influenced patients' vaccination rates in the following year. A further aim was to determine whether the patients had a better understanding of their increased infection risk following verbal education.
Methods The initial study carried out in 2015 consisted of a short face-to-face interview with 60 patients who suffered from autoimmune inflammatory rheumatic diseases. Following the interview, verbal information was given to the patients on their increased risk of infection, and the importance of vaccination, in particular the influenza and pneumococcal vaccine. After 1 year, the patients were contacted by means of a telephone call. They were interviewed with regards to their vaccination history and knowledge of their infection risk. Of the 60 patients, 2 had passed away. Therefore 58 patients were included in the study.
Results The study included patients with a variety of AIIRD including rheumatoid arthrtitis, ankylosing spondylitis and psoriatic arthritis. 60.3% were females and the mean age was 63.1 years (range 25 to 82 years). Influenza vaccination rates in the previous year improved from 37.9% in 2015 to 41.4% in 2016 (p=0.704). Pneumococcal vaccination rates improved from 6.9% to 17.2% (p=0.086). On questioning the patients regarding their knowledge of increased infection risk, there was no improvement following the verbal education. In fact 37.9% of patients questioned in 2015, and 34.5% in 2016 knew that they were at increased risk of infection because of their condition. 33% of patients studied in 2016 could recall that they had been advised to take vaccination because of their underlying condition or treatment. This improved from 7% in 2015 (p<0.005). The proportion of patients who could recall the vaccination advice given was significantly higher in those below 61 years (p<0.005). However, there were no significant gender difference (p=0.147).
Conclusions Verbal education resulted in more patients receiving the pneumococcal vaccination (although not statistically significant because of the small number involved). It also resulted in a significant increase in the number of patients who were able to recall that they were adviced to take vaccination because of their condition. However, only 33% could recall this after a year. Verbal education did not effect the number of patients who took the influenza vaccine and the patients' knowledge of their increased infection risk.
This study highlights that verbal education helps to improve vaccination rates in autoimmune inflammatory rheumatic diseases. However, the advice given tends to be forgotten by the majority of patients after one year. Thus repeated verbal education is necessary, particularly in elderly patients. Moreover other methods of education, such as written information in the form of leaflets, may be useful.
Disclosure of Interest None declared