title: Vaccination practices in patients with inflammatory bowel disease among general internal medicine physicians in the USA.
abstract: BACKGROUND
  Increasing prevalence of inflammatory bowel disease (IBD) poses significant challenges to medical community. Preventive medicine, including vaccination against opportunistic infections, is important in decreasing morbidity and mortality in patients with IBD. We conduct first study to evaluate general awareness and adherence to immunisation guidelines by primary care physicians in the USA.
  
  
  METHODS
  We administered an electronic questionnaire to the research panel of the American College of Physicians (ACP) assessing current vaccination practices, barriers to vaccination and provider responsibility for administering vaccinations and compared responses with the European Crohn's and Colitis Organization consensus guidelines and expert opinion from the USA.
  
  
  RESULTS
  All of surveyed physicians (276) had experience with patients with IBD and spent majority of their time in direct patient care. 49% of physicians took immunisation history frequently or always, and 76% reported never or rarely checking immunisation antibody titres with only 2% doing so routinely. 65% of physicians believed that primary care providers (PCPs) were responsible for determining patient's immunisation. Vaccine administration was felt to be the duty of primary care doctor 80% of the time. 2.5% of physicians correctly recommended vaccinations all the time. Physicians were more likely to recommend vaccination to immunocompetent than immunocompromised patients. Up to 23% of physicians would incorrectly recommend live vaccine to immunocompromised patients with IBD.
  
  
  CONCLUSIONS
  Current knowledge and degree of comfort among PCPs in the USA in preventing opportunistic infections in IBD population remain low. Management of patients with IBD requires structured approach to their healthcare maintenance in everyday practice, including enhanced educational policy aimed at primary care physicians.
authors.affiliation: Division of Gastroenterology, Department of Medicine, New York University School of Medicine/Langone Medical Center, New York, New York, USA.
authors.forename: Grigoriy E
authors.initials: GE
authors.lastname: Gurvits
authors.affiliation: Division of Gastroenterology, Department of Medicine, Beth Israel Medical Center, New York, New York, USA.
authors.forename: Gloria
authors.initials: G
authors.lastname: Lan
authors.affiliation: Department of Medicine, The Mount Sinai Hospital, New York, New York, USA.
authors.forename: Amy
authors.initials: A
authors.lastname: Tan
authors.affiliation: American College of Physicians Research Center, Philadelphia, Pennsylvania, USA.
authors.forename: Arlene
authors.initials: A
authors.lastname: Weissman
mesh_terms: D019983:Guideline Adherence; D007722:Health Knowledge, Attitudes, Practice; D006801:Humans; D016867:Immunocompromised Host; D015212:Inflammatory Bowel Diseases / Q000453:epidemiology*; D010818:Practice Patterns, Physicians' / Q000706:statistics & numerical data*; D011320:Primary Health Care; D011379:Prognosis; D011795:Surveys and Questionnaires; D014481:United States / Q000453:epidemiology; D014611:Vaccination
keywords: Crohn’s disease; PRIMARY CARE; immunodeficiency; ulcerative colitis; vaccination