title: Effects of Education and Information on Vaccination Behavior in Patients with Inflammatory Bowel Disease.
abstract: Despite the existence of international guidelines, vaccination in patients with inflammatory bowel disease (IBD) has not been integrated optimally. We developed a thorough education program, and compared its influence on vaccination rates with routine clinical practice in a tertiary IBD center.
  
  
  
  Between December 2014 and March 2015, we included 505 consecutive patients with IBD visiting our outpatient clinic (53% men, 72% Crohn's disease, median age 44 years). Vaccination data, including hepatitis B, influenza, pneumococcus, tetanus, and varicella zoster virus, as well as demographic data, were collected by a fellow in training or a certified gastroenterologist. Thereafter, patients were randomly assigned to group A receiving routine clinical practice or intervention group B receiving additional education by the IBD nurse with help of an information brochure and vaccination card. Vaccination status was reassessed 8 months later.
  
  
  
  At baseline, 32% of patients were vaccinated according to the guidelines. The remaining 346 patients were randomized to group A (n = 206) or intervention group B (n = 140). Eight months after randomization, 33% of intervention group B versus 6% of group A followed vaccination recommendations and differences were significant for each vaccine (all P < 0.001). A higher educational level was independently associated with better compliance to pneumococcal vaccination (P = 0.008) and to the guidelines overall (P < 0.001). However, the educational intervention was the only consistent factor independently associated with improved compliance to each individual vaccination recommendation (all P ≤ 0.023).
  
  
  
  Introduction of thorough vaccination education significantly increased compliance to vaccination guidelines. However, further education of patients and health care providers remains necessary.
authors.affiliation: *Department of Gastroenterology and Hepatology, University Hospitals Leuven, KU Leuven, Leuven, Belgium; †Department of Clinical and Experimental Medicine, Translational Research Center for Gastrointestinal Disorders (TARGID), KU Leuven, Leuven, Belgium; ‡Department of Internal Medicine, University Hospitals Leuven, KU Leuven, Belgium; and §Department of Microbiology and Immunology, KU Leuven, Leuven, Belgium.
authors.forename: Sofie
authors.initials: S
authors.lastname: Coenen
authors.forename: Ellen
authors.initials: E
authors.lastname: Weyts
authors.forename: Cedric
authors.initials: C
authors.lastname: Jorissen
authors.forename: Paul
authors.initials: P
authors.lastname: De Munter
authors.forename: Maja
authors.initials: M
authors.lastname: Noman
authors.forename: Vera
authors.initials: V
authors.lastname: Ballet
authors.forename: Séverine
authors.initials: S
authors.lastname: Vermeire
authors.forename: Gert
authors.initials: G
authors.lastname: Van Assche
authors.forename: Marc
authors.initials: M
authors.lastname: Ferrante
mesh_terms: D000328:Adult; D000368:Aged; D003093:Colitis, Ulcerative / Q000150:complications / Q000523:psychology; D003424:Crohn Disease / Q000150:complications / Q000523:psychology; D005260:Female; D006801:Humans; D007155:Immunologic Factors / Q000592:standards / Q000627:therapeutic use; D015212:Inflammatory Bowel Diseases / Q000150:complications / Q000523:psychology*; D008297:Male; D008875:Middle Aged; D010349:Patient Compliance / Q000523:psychology*; D010353:Patient Education as Topic / Q000379:methods*; D017410:Practice Guidelines as Topic; D014611:Vaccination / Q000523:psychology* / Q000592:standards; D014612:Vaccines / Q000592:standards / Q000627:therapeutic use; D055815:Young Adult
chemical_list: D007155:Immunologic Factors; D014612:Vaccines