ODP209 Impact of an Educational Intervention on Rates of Physician-Performed Counseling on COVID-19 Vaccination in Patients With Diabetes
Authors: Upadhyaya Neelam , Veluru Manasa , Wicks Cherie Vaz 
Published: November 2022

Background

Roughly half of the people who died from COVID-19 infection under the age of 65 years had diabetes mellitus(1). People with type 1 or 2 diabetes mellitus are 3 times more likely to be hospitalized or experience severe COVID-19 infection compared with people without diabetes mellitus(2). We aimed to evaluate the impact of an educational quality improvement intervention on the rates of physician-performed counseling for patients with diabetes mellitus regarding COVID-19 vaccination at a university hospital in an underserved community.

Methods

Patients 18 years and older with type 1 or 2 diabetes mellitus presenting from May 1st to October 31st, 2021 were included. Via chart review, we recorded the number of patients who were asked about their vaccination status and the number of unvaccinated patients who received verbal and/or written counseling before and after an educational intervention performed on August 1st. The intervention consisted of a formal presentation to endocrinology fellows on how to counsel patients with diabetes regarding COVID-19 vaccination and provided them a patient hand-out with answers to frequently asked questions and information on vaccination sites at the hospital and in the community.

Results

328 patients with diabetes, mean age 59 years, type 2 diabetes 92% (n=301) and type 1 diabetes 8% (n=27), were seen during the six month period. 82% (n=268) were vaccinated, 12% (n=40) were unvaccinated, and 6% (n=20) had unknown vaccination status. 56% (n=183) were asked about their vaccination status. Of the unvaccinated patients, 60% (n=24) were counseled. Prior to the intervention, 155 patients were seen and 31% (n=48) were asked about their vaccination status, 15% (n=23) were unvaccinated, and of the unvaccinated 39% (n=9) were counseled. After our intervention, 173 patients were seen and 78% (n=135) were asked about their vaccination status. 12% (n=12) were unvaccinated and of these 71% (n=15) were counseled. We found a statistically significant increase in rates of recording vaccination status (31% vs. 78%, p-value &lt;0. 001) and counseling rates for those unvaccinated (39% vs. 71%, p-value 0. 016) before and after the intervention. Of the total unvaccinated patients counseled throughout the six month period (n=24), 13% (n=3) received vaccination afterwards and 16% (n=4) did not receive vaccinations, while vaccination status remains unknown in 71% (n=17).

Conclusion

As patients with diabetes mellitus are at increased risk of severe disease from COVID-19, it is clinically meaningful for endocrinologists to counsel patients regarding COVID-19 vaccination. Following our educational intervention, we found a significant improvement in rates of physician-performed counseling on COVID-19 vaccination at a university hospital, caring for one of the nation's most underserved communities for diabetes mellitus. References: (1) MMWR Morb Mortal Wkly Rep. 2020;69(28): 923-929. (2) Diabetes Care. 2021;44(2): 526-532.

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