scholarly journals Implementing a Multidisciplinary Approach to Enhance Compliance With Guideline-Recommended Prechemotherapy Pneumococcal Vaccination in a Military-Based Medical Oncology Practice

2017 ◽  
Vol 13 (11) ◽  
pp. e966-e971 ◽  
Author(s):  
Wilfred Delacruz ◽  
Sandra Terrazzino ◽  
Michael Osswald ◽  
Casey Payne ◽  
Brian Haney
Keyword(s):  
Pneumococcal Vaccination ◽  
Standard Of Care ◽  
Baseline Period ◽  
Community Acquired Pneumonia ◽  
Vaccination Rates ◽  
Patients With Cancer ◽  
Single Person ◽  
Increased Risk ◽  
Oncology Practice ◽  
Current Guidelines

Purpose: Patients with cancer are at increased risk for invasive pneumococcal disease, including community-acquired pneumonia. Current Advisory Committee on Immunization Practices and National Cancer Comprehensive Network guidelines recommend pneumococcal vaccination for immunocompromised patients, including patients with cancer. Methods: We conducted a quality improvement (QI) project to enhance compliance with pneumococcal vaccination in patients before their chemotherapy. Baseline pneumococcal vaccination rates were gathered from July 2013 to June 2014. We reviewed the current guidelines for pneumococcal vaccinations in patients with cancer with physicians and encouraged them to prescribe the pneumococcal vaccination to patients before therapy. We also recruited our clinic nurse practitioner, who meets all patients for chemotherapy teaching, to prescribe the vaccine to patients younger than 65 years of age. Results: During the baseline period, of the 110 patients younger than 65 years who received chemotherapy, seven (6.4%) received the pneumococcal vaccine. Of the 90 patients (median age, 60 years; range, 20 to 86 years) who received chemotherapy during the study period, 58 were younger than 65 years, of whom three patients were already vaccinated before their diagnosis. Twenty-five (45.5%) patients were vaccinated through our QI project. We have improved our compliance with pneumococcal vaccination by 39% ( P < .001). Conclusion: We have improved compliance with pneumococcal vaccination in patients with cancer receiving chemotherapy in our clinic through a QI project. We found that screening is best accomplished by a single person who is able to screen all patients. This practice is now a standard of care in our clinic.

scholarly journals Flu and Pneumococcal Vaccine Coverage in Scleroderma Patients Still Need to Be Prompted: A Systematic Review

Vaccines ◽  
2021 ◽  
Vol 9 (11) ◽  
pp. 1330
Author(s):  
Francesca Rosamilia ◽  
Giovanni Noberasco ◽  
Dario Olobardi ◽  
Andrea Orsi ◽  
Giancarlo Icardi ◽  
...  
Keyword(s):  
Systematic Review ◽  
Vaccine Coverage ◽  
Pneumococcal Vaccination ◽  
Vaccination Rate ◽  
Vaccination Rates ◽  
Increased Risk ◽  
Flu Vaccine ◽  
Vaccination Campaigns ◽  
Low Coverage ◽  
Current Guidelines

Systemic sclerosis (scleroderma, SSc) is an autoimmune connective tissue disease characterized by excessive production of collagen and multiorgan involvement. Scleroderma patients are at increased risk of influenza complications and pneumonia; thus, vaccinations are recommended. This systematic review evaluated the influenza and pneumococcus vaccination coverage for SSc patients. We included all studies from Pubmed reporting on influenza and pneumococcal vaccination rate in Scleroderma patients up to May 2021. The 14 studies thus selected identified a suboptimal vaccination rate in autoimmune and SSc patients, ranging from 28 to 59% for the flu vaccine, and from 11 to 58% for the pneumo vaccine in absence of specific vaccination campaigns, variously considering also other variables such as age, gender, vaccination settings, and possible vaccination campaigns. We also considered the reasons for low coverage and the approaches that might increase the vaccination rates. A lack of knowledge about the importance of vaccination in these patients and their doctors underlined the need to increase the awareness for vaccination in this patients’ category. Current guidelines recommend vaccination in elderly people and people affected by particular conditions that widely overlap with SSc, yet autoimmune diseases are not always clearly mentioned. Improving this suboptimal vaccination rate with clear guidelines is crucial for SSc patients and for clinicians to immunize these categories based principally on the pathology, prior to the age. Recommendations by the immunologist and the direct link to the vaccine providers can highly improve the vaccine coverage.

A quality improvement project to increase compliance with indicated prechemotherapy pneumococcal vaccination.

2016 ◽  
Vol 34 (7_suppl) ◽  
pp. 218-218
Author(s):  
Wilfred P. Delacruz ◽  
Sandra Terrazzino ◽  
Brian R. Haney
Keyword(s):  
Quality Improvement ◽  
Cancer Patients ◽  
Pneumococcal Vaccination ◽  
Severe Pneumonia ◽  
Standard Of Care ◽  
High Morbidity ◽  
Improvement Project ◽  
Single Person ◽  
Improve Compliance ◽  
Current Guidelines

218 Background: Severe pneumonia is associated with high morbidity and mortality in cancer patients. The most common pathogen is S. pneumoniae, responsible for 2/3 of pneumonia-related deaths. Current guidelines recommend routine use of 13-valent (Prevnar 13) and 23-valent (PPSV23) pneumococcal vaccine for immunocompromised patients (cancer patients). Of the 110 patients younger than 65 years old who started chemotherapy in our clinic from July 2013 to June 2014, only seven patients received the pneumonia vaccine through our clinic. We conducted a quality improvement (QI) project to improve compliance of pneumonia vaccination in patients who will start on chemotherapy in our outpatient clinic. Methods: We reviewed the current guidelines for pneumonia vaccinations in cancer patients with our physicians and encouraged them to prescribe the pneumonia vaccination to their patients prior to therapy. In addition to educating the primary provider, we took a multidisciplinary approach and recruited our clinic nurse practitioner who meets all patients for chemotherapy teaching to prescribe the vaccine to patients less than 65. Results: Of the 90 patients (median age 60, 20-86) who started chemotherapy during the study period, 58 were less than 65 years old of which three patients were already vaccinated prior to their diagnosis. Twenty five (45.5%) patients were vaccinated through our QI project. We have improved our compliance with pneumonia vaccination guidelines by 39%. Conclusions: We have improved compliance of pneumonia vaccination in cancer patients starting chemotherapy in our clinic through a QI project. We found that screening and intervention are best accomplished by a single person who is able to see all patients. This practice is now being conducted as standard of care in our clinic.

scholarly journals Seasonal Influenza and Pneumococcal Vaccination Rates Among Patients with Cancer in COVID-19 Pandemic: A Cross-Sectional Study

2021 ◽  
Vol 7 (2) ◽  
pp. 64-70
Author(s):  
Emre YEKEDÜZ ◽  
Elif Berna KÖKSOY ◽  
Satı Coşkun YAZGAN ◽  
Ilgın AKBIYIK ◽  
Sevinç BALLI ◽  
...  
Keyword(s):  
Seasonal Influenza ◽  
Pneumococcal Vaccination ◽  
Cross Sectional Study ◽  
Sectional Study ◽  
Cross Sectional ◽  
Vaccination Rates ◽  
Patients With Cancer

scholarly journals The Prevention and treatment of cancer-associated thrombosis

2020 ◽  
Vol 27 (5) ◽  
Author(s):  
S. Ng ◽  
M. Carrier
Keyword(s):  
Low Molecular Weight Heparin ◽  
Oral Anticoagulants ◽  
Direct Oral Anticoagulants ◽  
Anticoagulation Therapy ◽  
Standard Of Care ◽  
Low Molecular Weight ◽  
Safe Alternative ◽  
Patients With Cancer ◽  
Increased Risk ◽  
Cancer Associated Thrombosis

Cancer is a hypercoagulable state with an associated increased risk of venous thromboembolism (vte) that is further amplified in individuals who undergo chemotherapy. Compared with patients having cancer alone or vte alone, patients who develop cancer-associated vte have a significantly poorer prognosis. The risks of recurrent vte despite appropriate anticoagulation therapy and of bleeding are also higher in patients with cancer than in those without. For those reasons, the prevention and appropriate management of cancer-associated thrombosis is of paramount importance. Although low-molecular-weight heparin has been the standard of care for the prevention and treat­ment of cancer-associated thrombosis, direct oral anticoagulants are increasingly being adopted as an effective and safe alternative.

scholarly journals Risk of community-acquired pneumonia requiring hospitalization in patients with spondyloarthritis

2020 ◽  
Vol 12 ◽  
pp. 1759720X2096261
Author(s):  
Ho Yin Chung ◽  
Lai Shan Tam ◽  
Shirley Chiu Wai Chan ◽  
Jason Pui Yin Cheung ◽  
Pui Yan Wong ◽  
...  
Keyword(s):  
Risk Factors ◽  
Cox Regression ◽  
Demographic Data ◽  
Pneumococcal Vaccination ◽  
Community Acquired Pneumonia ◽  
Vaccination Programs ◽  
Increased Risk ◽  
Drinking Status ◽  
Traditional Risk Factors ◽  
Micro Organisms

Aims: To compare the risk of community-acquired pneumonia (CAP) requiring hospitalization in spondyloarthritis (SpA) and non-specific back pain (NSBP), and to identify the risk factors for CAP in SpA. Methods: A total of 2984 patients with SpA from 11 rheumatology centers and 2526 patients with NSBP from orthopedic units were reviewed from the centralized electronic database in Hong Kong. Incidence of CAP requiring hospitalization and demographic data including age, gender, smoking and drinking status, use of sulfasalazine, individual biological-disease modifying anti-rheumatic drugs (DMARDs) used, micro-organisms, other immunosuppressants or immunosuppressive states, use of steroid for more than ½ year, and co-morbidities were identified. Risks of CAP in SpA were compared with those in NSBP using propensity score regression method. Multivariate Cox regression model was used to identify the risk factors in SpA. Results: CAP requiring hospitalization was found in 183 patients with SpA and 138 patients with NSBP. Increased risk for CAP was found in the following groups with SpA: all subgroups (hazard ratio (HR) 2.14, p < 0.001), without use of DMARDs (HR 2.64, p < 0.001), without psoriasis and not taking DMARDs (HR 2.38, p < 0.001). Infliximab (HR2.55, p = 0.04), smoking (HR 1.68, p = 0.003), comorbid psoriasis (HR 1.67, p = 0.003), and use of steroid for more than ½ year (HR 1.94, p = 0.003) were found to associate with CAP after adjustments for traditional risk factors. Conclusion: Risk of CAP is increased in patients with SpA. Our data favor universal influenza and pneumococcal vaccination programs in the population. Rheumatologists should also advise smoking cessation and avoid long term steroid therapy.

scholarly journals AB1141 EVALUATION OF INFLUENZA AND PNEUMOCOCCAL VACCINATION RATES IN PATIENTS WITH RHEUMATOID ARTHRITIS AND SPONDYLOARTHRITIS, AND THE AWARENESS OF RHEUMATOLOGISTS ABOUT VACCINATION

2020 ◽  
Vol 79 (Suppl 1) ◽  
pp. 1860.2-1861
Author(s):  
İ. Kurut Aysin ◽  
M. Aysin ◽  
D. Solmaz ◽  
N. Baş Tomaş ◽  
F. Koç ◽  
...  
Keyword(s):  
Rheumatoid Arthritis ◽  
Pneumococcal Vaccine ◽  
Inflammatory Arthritis ◽  
Pneumococcal Vaccination ◽  
Inflammatory Rheumatic Diseases ◽  
Pneumococcal Vaccines ◽  
Vaccination Rates ◽  
Factors Associated ◽  
Increased Risk ◽  
Rheumatology Outpatient

Background:Patients with inflammatory arthritis have increased risk of infections which may lead to morbidity and mortality. Some of those infections could be prevented by vaccination.Objectives:The main objectives of the present study were to investigate (a) the uptake rate of influenza and pneumococcal vaccination among patients with rheumatoid arthritis (RA) and spondyloarthritis (SpA) attending a rheumatology outpatient clinic, (b) the factors associated with their vaccination rate and, (c) the attitudes of Turkish rheumatologists about vaccination.Methods:Patients, followed-up in a tertiary rheumatology outpatient clinic with the diagnosis of RA and SpA, volunteered for participating to study, were included in this cross-sectional study. Data regarding the socio-demographic and disease-related characteristics (including disease duration, medications used, and comorbid conditions) of the patients, vaccination history, the knowledge about the vaccination, and the factors potentially associated with the uptake of vaccination were collected by face-to-face interview using a standardized questionnaire. 102 out of 345 rheumatologists have participated in a web-based survey.Results:In total, we collected data from 387 patients (260 with SpA and 114 with RA; 204 [52.8%] female and mean age 46.6 ± 12.7 years). Only 123 (32.3%) of our patients were responded that their disease or treatment might be related to the increased risk for infectious diseases. Influenza and pneumococcal vaccines were administered to 71 (21.4%) and 21 (6.1%) patients, respectively. Vaccination for influenza was recommended by family physicians in 26 patients and by rheumatologists in 12 patients. Rate of influenza vaccination was significantly higher in patients >65 years (p=0.021) and with any co-morbid conditions (p=0.002). The main reasons reported by patients regarding not to be vaccination were (a) the belief that they did not need the vaccine (49.4% for influenza and 26.2% for pneumococcal vaccine), (b) the absence of recommendation from their physicians (24.1% for influenza and 26.2% for pneumococcal vaccine), (c) fear of adverse event of vaccination (28.8% for influenza and 3.2% for pneumococcal vaccine), and (d) lack of knowledge about vaccination (6.1% for influenza and 12.5% for pneumococcal vaccine). Even though 50% of rheumatologists who responded to the survey were aware of the presence of national vaccination recommendations, all of them stated that patients with inflammatory arthritis need to be vaccinated for both influenza and pneumococcal infections. Influenza and pneumococcal vaccines were administered to 23 (22.5%) and 4 (3.9%) rheumatologists, respectively.Conclusion:Although the knowledge and awareness about influenza and pneumococcal vaccinations were seemed to be high among rheumatologists, vaccination rates for both were insufficient in RA and SpA patients. There remains significant effort to improve vaccination rates and to prevent morbidity and mortality due to vaccine-preventable infections in inflammatory rheumatic diseases.References:[1]Van Assen S, Agmon-Levin N, Elkayam O, Cervera R, Doran MF, Dougados M, et al. EULAR recommendations for vaccination in adult patients with autoimmune inflammatory rheumatic diseases. Ann Rheum Dis 2011;70:414–22.[2]MTT Nguyen, H Lindegaard, O Hendricks & N Friis-Møller. Factors associated with influenza and pneumococcal vaccine uptake among rheumatoid arthritis patients in Denmark invited to participate in a pneumococcal vaccine trial (Immunovax_RA), Scandinavian Journal of Rheumatology 2017;1–8.Disclosure of Interests:None declared

scholarly journals An observational study on pneumococcal and influenza vaccination status of patients with type 2 diabetes mellitus

2018 ◽  
Vol 6 (12) ◽  
pp. 3842
Author(s):  
Rafiq A. Bhat ◽  
Saleem A. Wani ◽  
Rajat Kharbanda ◽  
Sumit Sethi
Keyword(s):  
Diabetes Mellitus ◽  
Type 2 Diabetes ◽  
Type 2 Diabetes Mellitus ◽  
Pneumococcal Disease ◽  
Pneumococcal Vaccination ◽  
Vaccination Rates ◽  
Vaccination Uptake ◽  
Increased Risk ◽  
Patients With Diabetes

Background: India has more than sixty million subjects with diabetes. Diabetes confers an increased risk of developing and dying from infectious diseases with an enhanced susceptibility to morbidity, mortality and hospitalizations due to influenza and pneumococcal disease. The Advisory Committee on Immunization Practices (ACIP) recommends influenza and pneumococcal vaccines for all individuals with diabetes.Methods: Around 249 patients with type 2 diabetes mellitus were enrolled in the study. All patients were asked a detailed history about diabetes, its duration, type of diabetes and the vaccinations for influenza and pneumococcus, who suggested vaccination and the reasons for declining the vaccination if it had been medically advised. Any other co-morbid condition such as hypertension, diabetes mellitus, heart disease, COPD, hypothyroidism and CKD were noted.Results: Vaccination rates for influenza in patients aged 50 or more were higher (7.6% of 172 patients) as compared to those aged <50 years (0% of 77); (p=0.013) whereas pneumococcal vaccination rates were 8.1% as against 1.3% (p=0.036) respectively. In males the vaccination rates for influenza were 4.7% compared to females (5.8%); (p=0.675), whereas for pneumococcus the respective vaccination rates were 6.2% for male and 5.8% for female (p=0.903). Vaccination uptake among male and female were almost same. Patients having chronic kidney disease on dialysis were having highest vaccination rate.Conclusions: The poor vaccination uptake for influenza and pneumococcus in patients with diabetes, calls for intensive efforts aimed at increasing coverage.

Port in oncology practice: 3-monthly locking with normal saline for catheter maintenance, a preliminary report

2017 ◽  
Vol 18 (4) ◽  
pp. 325-327 ◽  
Author(s):  
Gianfranca Solinas ◽  
Francesca Platini ◽  
Maurizio Trivellato ◽  
Carla Rigo ◽  
Oscar Alabiso ◽  
...  
Keyword(s):  
Cancer Patients ◽  
Normal Saline ◽  
Venous Access ◽  
Central Venous ◽  
Patients With Cancer ◽  
Increased Risk ◽  
Wide Range ◽  
Oncology Practice ◽  
The Right

Introduction Patients with cancer need stable venous access using central vascular devices like central venous ports and peripherally inserted central catheters that can be used for a wide range of indications. Numerous flushing protocols exist including different frequencies for catheter locking to maintain catheter patency. The aim of this retrospective study was to evaluate the incidence of lumen occlusion of central venous ports in a group of adult cancer patients, adopting a policy of locking with normal saline every three months. Methods This is a single-center retrospective observational study. During follow-up, we analyzed adult cancer patients who had undergone port insertion from January 1st, 2007 to August 31st, 2014. Flushing and locking were performed every three months with a syringe containing normal saline. Results We collected data from 381 patients with ports inserted in subclavian vein (379 patients) and in the right jugular vein (2 patients). Locking was performed during 3-monthly follow-up visits. Median follow-up was 810 days (90-2700 days). Among 381 ports, 59 were removed; the reasons for removal were: end of use (45 cases), catheter rupture (9 cases), dislocation (3 cases) and catheter-related bloodstream infection (2 cases). We had no reports of lumen occlusion. Conclusions Our data suggest that locking ports with normal saline every three months is not associated with an increased risk of lumen occlusion.

COVID-19 AND ITS IMPACT ON RADIATION ONCOLOGY PRACTICE IN INDIA.

2021 ◽  
pp. 66-68
Author(s):  
Vasudha Kesarwani ◽  
Divya Kesarwani
Keyword(s):  
Targeted Therapy ◽  
Infection Control ◽  
Radiation Oncology ◽  
Work Load ◽  
Respiratory Viruses ◽  
Load Management ◽  
Staff Education ◽  
Patients With Cancer ◽  
Increased Risk ◽  
Oncology Practice

Patients with cancer are known to be at an increased risk for community-acquired respiratory viruses, because of their frequently observed systemic immunosuppressive state caused by the malignancy and anticancer treatments, such as chemotherapy, targeted therapy and immunotherapy. In this study different challenges of radiation oncology department and their infection control practices are given such as Pt screening, temperature monitoring and pt staff education, hygiene and departmental cleaning, zoning,work load management etc.There must be national and departmental measures to be taken in response to covid 19 pandemic.Some of risk adapted triage strategies for radiotherapy patients during covid 19 is discussed further. Comparison between covishield, covaxin and sputnik V covid 19 vaccines and lack of vaccine prioritisation for cancer patients in India have been elaborated.

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