Amy G Feldman1, Rebekah Marsh2, Allison Kempe3, Megan A Morris4. 1. Section of Gastroenterology, Hepatology and Nutrition and the Digestive Health Institute, Adult and Child Consortium for Health Outcomes Research and Delivery Science (ACCORDS), University of Colorado School of Medicine & Children's Hospital Colorado, Aurora, CO. Electronic address: amy.feldman@childrenscolorado.org. 2. Adult and Child Consortium for Health Outcomes Research and Delivery Science (ACCORDS), University of Colorado, Aurora, CO. 3. Department of Pediatrics, Adult and Child Consortium for Health Outcomes Research and Delivery Science (ACCORDS) University of Colorado School of Medicine & Children's Hospital Colorado, Aurora, CO. 4. Adult and Child Consortium for Health Outcomes Research and Delivery Science (ACCORDS), University of Colorado & Children's Hospital Colorado, Aurora, CO.
Abstract
OBJECTIVES: To describe the experiences and beliefs of pediatric transplant stakeholders regarding factors that contribute to low pretransplant immunization rates. STUDY DESIGN: Semistructured interviews were conducted with transplant team members (hepatologists, cardiologists, nephrologists, transplant nurse coordinators, and transplant infectious diseases physicians), primary care physicians, and parents of heart, liver, and kidney transplant recipients at 3 geographically diverse large pediatric transplant centers in the US. Interviews were conducted between July 2017 and February 2020 until thematic saturation was reached within each stakeholder subgroup. Content analysis methodology was used to identify themes. RESULTS: Stakeholders participated in 30- to 60-minute interviews (16 transplant subspecialists, 3 transplant infectious diseases physicians, 11 transplant nurse coordinators, 12 primary care physicians, and 40 parents). Five central themes emerged: (1) gaps in knowledge about timing and safety of pretransplant immunizations, (2) lack of communication, coordination, and follow-up between team members regarding immunizations, (3) lack of centralized immunization records, (4) subspecialty clinic functioning as the medical home for transplant candidates but unable to provide all needed immunizations, and (5) differences between organ type in prioritization and completion of pretransplant immunization. CONCLUSIONS: There are multiple factors that contribute to low immunization rates among pediatric transplant candidates. New tools are needed to overcome these barriers and increase immunization rates in transplant candidates.
OBJECTIVES: To describe the experiences and beliefs of pediatric transplant stakeholders regarding factors that contribute to low pretransplant immunization rates. STUDY DESIGN: Semistructured interviews were conducted with transplant team members (hepatologists, cardiologists, nephrologists, transplant nurse coordinators, and transplant infectious diseases physicians), primary care physicians, and parents of heart, liver, and kidney transplant recipients at 3 geographically diverse large pediatric transplant centers in the US. Interviews were conducted between July 2017 and February 2020 until thematic saturation was reached within each stakeholder subgroup. Content analysis methodology was used to identify themes. RESULTS: Stakeholders participated in 30- to 60-minute interviews (16 transplant subspecialists, 3 transplant infectious diseases physicians, 11 transplant nurse coordinators, 12 primary care physicians, and 40 parents). Five central themes emerged: (1) gaps in knowledge about timing and safety of pretransplant immunizations, (2) lack of communication, coordination, and follow-up between team members regarding immunizations, (3) lack of centralized immunization records, (4) subspecialty clinic functioning as the medical home for transplant candidates but unable to provide all needed immunizations, and (5) differences between organ type in prioritization and completion of pretransplant immunization. CONCLUSIONS: There are multiple factors that contribute to low immunization rates among pediatric transplant candidates. New tools are needed to overcome these barriers and increase immunization rates in transplant candidates.
Authors: Melissa S Stockwell; Elyse Olshen Kharbanda; Raquel Andres Martinez; Celibell Y Vargas; David K Vawdrey; Stewin Camargo Journal: JAMA Date: 2012-04-25 Impact factor: 56.272
Authors: Amy G Feldman; Shikha S Sundaram; Brenda L Beaty; Richard Torres; Donna J Curtis; Allison Kempe Journal: JAMA Date: 2019-11-12 Impact factor: 56.272
Authors: Jenelle L Mellerson; Choppell B Maxwell; Cynthia L Knighton; Jennifer L Kriss; Ranee Seither; Carla L Black Journal: MMWR Morb Mortal Wkly Rep Date: 2018-10-12 Impact factor: 17.586
Authors: Amy G Feldman; Susan Moore; Sheana Bull; Megan A Morris; Kumanan Wilson; Cameron Bell; Margaret M Collins; Kathryn M Denize; Allison Kempe Journal: JMIR Form Res Date: 2022-01-13