S3328 Survey Assessment of Knowledge, Attitudes, and Barriers to Providing Vaccinations to Inflammatory Bowel Disease Patients in Gastroenterology Fellows Clinic

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Introduction: Inflammatory bowel disease (IBD) patients have lower rates of vaccination compared with the general population. Research has shown that IBD patients on immunosuppressive therapy are at increased risk for vaccine preventable illness. The aim of this study was to determine the underlying reasons in Gastroenterology Fellows Clinic that vaccinations were not being ordered. Methods: A survey was sent to Gastroenterology Fellow Physicians to assess knowledge, attitudes, and barriers to providing vaccinations for IBD patients at clinic visits. There were ten fellows in total surveyed. We asked fellows to rank insufficient time, uncertainty of clinic workflow, workflow in clinic is too time consuming, uncertainty of vaccine availability in clinic, uncertain of insurance coverage, patient uninsured, and attending physician does not inquire about vaccination status. Survey question responses were analyzed and frequencies and percentages were obtained for categorical variables and medians (IQR: interquartile range) for continuous variables. Results: On a scaled survey questions (0-100) we found most fellows felt familiar with current recommendations on vaccinations [median score 75 (IQR: 69-94)] but 50% later cited a lack of knowledge as contributing to not ordering vaccinations. Most fellows believed that ordering vaccinations was an important practice [median score 92 (IQR: 80-100)]. The majority of fellows felt insufficient visit time affected their decision [median score 87 (IQR: 50-100)]. When asked to rank the reasons why they have not ordered vaccinations for IBD during GI clinics, the most applicable response was ‘forgetting to address during patient visit’ (30% said most applicable, 50% said somewhat applicable). We found that 83% of fellows found uncertainty to workflow was a very important reason or occasional reason for not ordering vaccinations. Furthermore, 80% felt the attending not inquiring about vaccination status was a very important or an occasional reason. Conclusion: Based on our study, we found that there were many factors impacting whether fellows order vaccinations in IBD patients during clinic visit including insufficient time, uncertainty of clinic workflow, and attendings not inquiring about vaccinations. Most fellows felt lack of knowledge was contributory. Further directions include increasing fellow familiarity with clinic workflow and vaccination indications in IBD patients to determine if vaccination rates can be increased.

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