Nurse-led program increases pneumococcal vaccine rates in patients with chronic inflammatory rheumatic disease

In patients with chronic inflammatory rheumatic diseases, the implementation of a program run by nurses may significantly improve pneumococcal vaccination coverage, according to research presented at the annual meeting of the European Congress of Rheumatology (EULAR 2017).

Because these patients may be treated with immunosuppressive therapy, they are at high risk for developing invasive pneumococcal disease. Vaccination rates in this population are still low, despite national and EULAR recommendations for vaccination.

“Patients with chronic inflammatory rheumatic diseases and receiving immunosuppressive therapies are at increased risk of dying from infections compared with the general population. Pneumococci are one of the causative pathogens,” said lead author Tiphaine Goulenok, MD, Bichat Hospital, Paris, France. “Our study has shown that nurses can play an important role in improving the uptake of pneumococcal vaccination in these vulnerable patients.”

Dr. Goulenok and colleagues screened 126 consecutive adults with a chronic inflammatory rheumatic disease who were admitted to the day hospital unit at Bichat Hospital over 4 months. According to French national recommendations, 76 subjects were candidates for pneumococcal vaccination due to treatment with prednisone, immunosuppressive drugs, or biotherapy.

Before a nurse-led pneumococcal vaccination program was introduced, only 17% of these patients were vaccinated (n=13). Of the remaining 63 patients who were vaccination candidates but not vaccinated, 89% (n=56) had been identified by the nursing staff as requiring vaccination. After receiving education about both the benefits and risks of vaccination, 46 patients agreed to be vaccinated.

Researchers found a significant improvement in vaccination coverage when comparing vaccination rates before and after the introduction of this program (P < 0.001).