An Implementation Project to Improve Provider Recommendation of Immunizations in Adult Patients Receiving Biologic Agents as a Treatment for Psoriasis

Abstract

Session presented on Sunday, July 26, 2015: Purpose: Psoriasis is the most prevalent autoimmune disorder in the United States, affecting approximately 7.5 million individuals. Patients with psoriasis may suffer from painful and debilitating symptoms, including papulosquamous skin lesions and psoriatic arthritis. One effective psoriasis treatment is the use of biologic agents, which target psoriasis at the level of the immune system. One negative result of the use of biologic agents is the overall suppression of the patient's immune system, making patients receiving biologic agents vulnerable to infection. Guidelines released by the National Psoriasis Foundation (NPF) in 2013 recommend that patients remain up to date with immunizations to prevent infection. Currently, there is a gap in care, where primary care providers monitor immunizations and specialty providers prescribe biologic agents. One simple strategy to improve care is to implement a provider reminder to improve immunization recommendation rates. The purpose of this study is to disseminate research findings for implementation of a patient questionnaire that serves as a provider reminder to recommend immunizations to this vulnerable population, in accordance with new National Psoriasis Foundation guidelines. Methods: An observational study was performed, where questionnaire was developed to determine whether patients recieved herpes zoster, influenza or pneumonvax immunizations. This questionnaire also served as a provider reminder to recommend immunizations. Provider notes were then analyzed to determine whether or not a recommendation was made to the patient to get the necessary immunization. Results: The preliminary results of this research study show that a provider reminder is an effective strategy to improve provider review of immunizations and to improve recommendation of influenza vaccine. Herpes zoster and pneumovax recommendations were not improved by use of provider reminder in preliminary data analysis. Conclusion: In progress