title: Rheumatologists fail to advise people with RA to get immunised, which matters if you are under 65: An audit in a New Zealand rheumatology service.
abstract: OBJECTIVE
  To assess if yearly-influenza and five-yearly pneumococcal vaccines are recommended to people with rheumatoid arthritis (RA) in a New Zealand rheumatology service in accordance with guidelines and determine patient immunisation status for these respiratory pathogens.
  
  
  METHODS
  Retrospective review of electronic health records of all outpatients with RA attending a regional rheumatology centre in New Zealand over a one-month period immediately after the release of the 2015 influenza vaccination.
  
  
  RESULTS
  The 232 people with RA in the sample had a mean age of 60.4 years with 59% having RA for more than five years. Documented advice was infrequent (<5%) at the index visit and other clinically relevant time points. Despite this, many patients were immunised. People with RA over 65 years of age were more likely to receive influenza vaccination, however, the vaccination rate was similar to the general population over 65 years of age.
  
  
  CONCLUSIONS
  People with RA receive recommended respiratory vaccinations despite infrequent advice for immunisation from rheumatology specialist services. However, immunisation rate in people with RA, particularly those under 65 years, remains suboptimal and multi-level interventions are required to improve this.
authors.affiliation: Registrar, Hutt Valley DHB.
authors.forename: Brendan
authors.initials: B
authors.lastname: Ng
authors.affiliation: General Practitioner, University of Otago, Wellington.
authors.forename: Lynn
authors.initials: L
authors.lastname: McBain
authors.affiliation: Rheumatologist, Wellington Regional Rheumatology Unit and University of Otago, Wellington.
authors.forename: Rebecca
authors.initials: R
authors.lastname: Grainger
mesh_terms: D001172:Arthritis, Rheumatoid / Q000150:complications*; D054869:Clinical Audit; D005260:Female; D006801:Humans; D007252:Influenza Vaccines / Q000627:therapeutic use*; D007251:Influenza, Human / Q000150:complications / Q000517:prevention & control*; D008297:Male; D008875:Middle Aged; D009520:New Zealand; D012189:Retrospective Studies; D000072140:Rheumatologists / Q000592:standards*; D012219:Rheumatology / Q000458:organization & administration*; D011795:Surveys and Questionnaires; D014611:Vaccination / Q000592:standards*
chemical_list: D007252:Influenza Vaccines