Key result
HF disease management programs are linked to flu and pneumococcal vaccination rates increasing to ~61%.
Why the study?
Vaccination rates in patients with systolic heart failure are low, and disparities by age, race, ethnicity, or sex are unclear.
Does a standardized vaccination approach improve immunization rates in patients with systolic heart failure?
Cohort (n=549)
No
Does a standardized vaccination approach improve immunization rates in patients with systolic heart failure?
Absolute Event Rate: 60.5% vs 22%
Implementation of a standardized vaccination protocol within a heart failure disease management program significantly improves influenza and pneumococcal immunization rates without introducing demographic disparities.
May improve vaccination rates in HF disease management; hypothesis-generating and requires randomized confirmation before practice change.
Healthy People 2010 aims at immunizing 60% of high-risk adults annually against influenza and once against pneumococcal disease. The aim of this study was to evaluate the use of a standardized approach to improve vaccination rates in patients with heart failure (HF); to determine whether disparities exist based on age, race, ethnicity, or sex at baseline and follow-up; and to evaluate the impact of clinical variables on the odds of being vaccinated. A prospective study of 549 indigent patients enrolled in a systolic HF disease management program (HFDMP) began enrollment from August 2007 to January 2009 at Jackson Memorial Hospital. Patients were interviewed at their initial visit for immunization status; those without vaccinations were offered the vaccines. Prevalence of vaccination (POV) for influenza and pneumococcal disease was obtained at baseline and at follow-up. The odds ratio for being vaccinated was calculated using logistic regression. The study population comprised mostly Hispanic (56%), black (37%), and male (70%) patients, with a mean age of 56 ± 12 years and a mean ejection fraction of 25% ± 10%. The initial POV for both was 22% at baseline. At follow-up, POV improved to 60.5%. Of those not vaccinated at baseline, 17.5% refused vaccination. Odds ratios at baseline for age, race/ethnicity, and sex were 0.99 (P=.99), 0.63 (P=.08), and 0.62 (P=.14), respectively. These did not change significantly at follow-up. Prevalence of vaccination in our cohort was low. Enrollment into the HFDMP improved immunization prevalence without creating age, race, ethnicity, or sex disparities.
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Hebert et al. (2010) conducted a cohort in Systolic heart failure (n=549). Heart failure disease management program (HFDMP) vs. Baseline was evaluated on Prevalence of vaccination for influenza and pneumococcal disease. Enrollment in a heart failure disease management program improved the prevalence of influenza and pneumococcal vaccination from 22% at baseline to 60.5% at follow-up.
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