Article Text
Abstract
Introduction While most men diagnosed with prostate cancer die from causes other than their cancer, many think that subsequent care focuses on their prostate cancer-related issues. We investigated whether influenza and pneumococcal vaccination practices were diminished in a cohort of men following their diagnosis of prostate cancer, in an environment that has implanted an electronic health record with multiple redundant reminders.
Methods We used information collected as part of the California Mens Health Study, a prospective cohort study of nearly 40 000 men ages 45–69 years at baseline in 2002 who were recruited through the Kaiser Permanente Southern California Health Plan. We identified all 1636 men who were newly diagnosed with prostate cancer from 2002 through 2008 and examined the use of influenza vaccine in the year prior to and subsequent to their cancer diagnosis, in the period before and after the introduction of the electronic health record.
Results Of the 973 and 663 men with prostate cancer in the pre- and post-electronic era, 312 (33%) and 391 (59%) had an influenza vaccine in the year prior to diagnosis compared to 374 (39%) and 406 (61%) in the years following (Matched OR (95% CI) 4.84 (3.62 to 6.47) and 1.64 (1.14 to 2.36)). Similar results were obtained when expanded to 2 years.
Conclusion These data suggest that once diagnosed with prostate cancer, no less attention is paid to preventive care as measured by influenza vaccination. Moreover, even with the dramatic increases in vaccination rates associated with the electronic record, there remained a significant improvement following cancer diagnosis.