Patient Safety Goals recently issued by the Joint Commission (JCAHO), as well as current CDC Guidelines, recommend Pneumococcus and annual Influenza vaccinations for all cancer patients over 65 and 50 years of age, respectively. The extent of compliance with these recommendations by patients receiving radiation therapy, and the potential reasons for lack of compliance, appears not to have been previously investigated.
Materials/Methods
Consecutive outpatients were asked to complete anonymous surveys in our Department from August 2006 through January 2007. Queries addressed both types of vaccinations. Patients who reported not receiving either vaccine were further queried regarding potential reasons for the omission.
Results
Responses were obtained from 207 patients; 98% were complete and evaluated. Over 36% of patients ≥65 reported never having received the Pneumococcus vaccine, while 25% of patients ≥50 reported never having received the Influenza vaccine. The most common reasons cited by patients for omission of either vaccine was that they “did not know about it”; believed they “do not need it”; or their “physician(s) did not recommend it”. These three factors accounted for almost 80% of patient noncompliance with vaccination guidelines. While 44% of patients who received either vaccine reported that they were asked or informed about these vaccines by their family physicians or internists, only 7% reported being asked or informed by their oncologists.
Conclusions
A substantial proportion of patients undergoing radiation therapy have not received vaccinations as recommended by national guidelines. The reasons cited for lack of compliance seem correctable. As many cancer patients are susceptible to potentially life-threatening infections that these vaccines prevent, our findings reveal a substantial gap in the comprehensive care of cancer patients that, if rectified, should improve their outcome after cancer treatment.
Dept. of Radiation Oncology, Hospital of the University of Pennsylvania, Philadelphia, PA
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