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Physicians Infrequently Adhere to Hepatitis Vaccination Guidelines for Chronic Liver Disease

Thudi, K and Yadav, D and Sweeney, K and Behari, J (2013) Physicians Infrequently Adhere to Hepatitis Vaccination Guidelines for Chronic Liver Disease. PLoS ONE, 8 (7).

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Background and Goals:Hepatitis A (HAV) and hepatitis B (HBV) vaccination in patients with chronic liver disease is an accepted standard of care. We determined HAV and HBV vaccination rates in a tertiary care referral hepatology clinic and the impact of electronic health record (EHR)-based reminders on adherence to vaccination guidelines.Methods:We reviewed the records of 705 patients with chronic liver disease referred to our liver clinic in 2008 with at least two follow-up visits during the subsequent year. Demographics, referral source, etiology, and hepatitis serology were recorded. We determined whether eligible patients were offered vaccination and whether patients received vaccination. Barriers to vaccination were determined by a follow-up telephone interview.Results:HAV and HBV serologic testing prior to referral and at the liver clinic were performed in 14.5% and 17.7%; and 76.7% and 74% patients, respectively. Hepatologists recommended vaccination for HAV in 63% and for HBV in 59.7% of eligible patients. Patient demographics or disease etiology did not influence recommendation rates. Significant variability was observed in vaccination recommendation amongst individual providers (30-98.6%), which did not correlate with the number of patients seen by each physician. Vaccination recommendation rates were not different for Medicare patients with hepatitis C infection for whom a vaccination reminder was automatically generated by the EHR. Most patients who failed to get vaccination after recommendation offered no specific reason for noncompliance; insurance was a barrier in a minority.Conclusions:Hepatitis vaccination rates were suboptimal even in an academic, sub-speciality setting, with wide-variability in provider adherence to vaccination guidelines. © 2013 Thudi et al.


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Item Type: Article
Status: Published
CreatorsEmailPitt UsernameORCID
Thudi, K
Yadav, Ddhy2@pitt.eduDHY2
Sweeney, K
Behari, Jjab31@pitt.eduJAB31
ContributionContributors NameEmailPitt UsernameORCID
Date: 26 July 2013
Date Type: Publication
Journal or Publication Title: PLoS ONE
Volume: 8
Number: 7
DOI or Unique Handle: 10.1371/journal.pone.0071124
Schools and Programs: School of Medicine > Medicine
Refereed: Yes
Article Type: Review
Date Deposited: 30 Aug 2013 17:07
Last Modified: 02 Feb 2019 16:58


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