tetano
Editor, Senior Moderator
J Gen Intern Med. 2019 Jul 19. doi: 10.1007/s11606-019-05164-7. [Epub ahead of print]
[h=1]Survey of Adult Influenza Vaccination Practices and Perspectives Among US Primary Care Providers (2016-2017 Influenza Season).[/h] Cataldi JR[SUP]1,[/SUP][SUP]2[/SUP], O'Leary ST[SUP]3,[/SUP][SUP]4[/SUP], Lindley MC[SUP]5[/SUP], Hurley LP[SUP]3,[/SUP][SUP]6[/SUP], Allison MA[SUP]3,[/SUP][SUP]4[/SUP], Brtnikova M[SUP]3,[/SUP][SUP]4[/SUP], Beaty BL[SUP]3[/SUP], Crane LA[SUP]3,[/SUP][SUP]7[/SUP], Kempe A[SUP]3,[/SUP][SUP]4[/SUP].
[h=3]Author information[/h]
[h=3]Abstract[/h] [h=4]BACKGROUND:[/h] Seasonal influenza vaccination is recommended for all adults; however, little is known about how primary care physicians can communicate effectively with patients about influenza vaccination.
[h=4]OBJECTIVE:[/h] To assess among general internal medicine (GIM) and family physicians (FP) regarding adult influenza vaccination: (1) recommendation and administration practices, (2) barriers to discussing and perceived reasons for patient refusal, and (3) factors associated with physician self-efficacy in convincing patients to be vaccinated.
[h=4]DESIGN:[/h] Email and mail survey conducted in February-March 2017 PARTICIPANTS: Nationally representative sample of GIM and FP MAIN MEASURES: Factor analysis was used to group similar items for multivariable analysis of barriers and strategies associated with high physician self-efficacy about convincing patients to be vaccinated (defined as disagreeing that they could do nothing to change resistant patients' minds).
[h=4]KEY RESULTS:[/h] Response rate was 67% (620/930). Ninety-eight percent always/almost always recommended influenza vaccine to adults ≥ 65 years, 90% for adults 50-64 years, and 75% for adults 19-49 years. Standing orders (76%) and electronic alerts (64%) were the most commonly used practice-based immunization strategies. Frequently reported barriers to discussing vaccination were other health issues taking precedence (41%), time (29%), and feeling they were unlikely to change patients' minds (24%). Fifty-eight percent of physicians reported high self-efficacy about convincing patients to be vaccinated; these providers reported fewer patient belief barriers contributing to vaccine refusal (RR = 0.93 per item; 95% CI (0.89-0.98); Cronbach's α = 0.70), were more likely to report using both fact- (1.08/item; (1.03-1.14); 0.66) and personal experience-based (1.07/item; (1.003-1.15); 0.65) communication strategies, and were more likely to work in practices using patient reminders for influenza vaccine (1.32; (1.16-1.50)).
[h=4]CONCLUSIONS:[/h] Physicians identified barriers to successfully communicating about adult influenza vaccination but few effective strategies to counter them. Interventions to promote self-efficacy in communication and under-utilized practice-based immunization strategies are needed.
[h=4]KEYWORDS:[/h] immunization delivery; influenza; physician communication; vaccination
PMID: 31325130 DOI: 10.1007/s11606-019-05164-7
[h=1]Survey of Adult Influenza Vaccination Practices and Perspectives Among US Primary Care Providers (2016-2017 Influenza Season).[/h] Cataldi JR[SUP]1,[/SUP][SUP]2[/SUP], O'Leary ST[SUP]3,[/SUP][SUP]4[/SUP], Lindley MC[SUP]5[/SUP], Hurley LP[SUP]3,[/SUP][SUP]6[/SUP], Allison MA[SUP]3,[/SUP][SUP]4[/SUP], Brtnikova M[SUP]3,[/SUP][SUP]4[/SUP], Beaty BL[SUP]3[/SUP], Crane LA[SUP]3,[/SUP][SUP]7[/SUP], Kempe A[SUP]3,[/SUP][SUP]4[/SUP].
[h=3]Author information[/h]
[h=3]Abstract[/h] [h=4]BACKGROUND:[/h] Seasonal influenza vaccination is recommended for all adults; however, little is known about how primary care physicians can communicate effectively with patients about influenza vaccination.
[h=4]OBJECTIVE:[/h] To assess among general internal medicine (GIM) and family physicians (FP) regarding adult influenza vaccination: (1) recommendation and administration practices, (2) barriers to discussing and perceived reasons for patient refusal, and (3) factors associated with physician self-efficacy in convincing patients to be vaccinated.
[h=4]DESIGN:[/h] Email and mail survey conducted in February-March 2017 PARTICIPANTS: Nationally representative sample of GIM and FP MAIN MEASURES: Factor analysis was used to group similar items for multivariable analysis of barriers and strategies associated with high physician self-efficacy about convincing patients to be vaccinated (defined as disagreeing that they could do nothing to change resistant patients' minds).
[h=4]KEY RESULTS:[/h] Response rate was 67% (620/930). Ninety-eight percent always/almost always recommended influenza vaccine to adults ≥ 65 years, 90% for adults 50-64 years, and 75% for adults 19-49 years. Standing orders (76%) and electronic alerts (64%) were the most commonly used practice-based immunization strategies. Frequently reported barriers to discussing vaccination were other health issues taking precedence (41%), time (29%), and feeling they were unlikely to change patients' minds (24%). Fifty-eight percent of physicians reported high self-efficacy about convincing patients to be vaccinated; these providers reported fewer patient belief barriers contributing to vaccine refusal (RR = 0.93 per item; 95% CI (0.89-0.98); Cronbach's α = 0.70), were more likely to report using both fact- (1.08/item; (1.03-1.14); 0.66) and personal experience-based (1.07/item; (1.003-1.15); 0.65) communication strategies, and were more likely to work in practices using patient reminders for influenza vaccine (1.32; (1.16-1.50)).
[h=4]CONCLUSIONS:[/h] Physicians identified barriers to successfully communicating about adult influenza vaccination but few effective strategies to counter them. Interventions to promote self-efficacy in communication and under-utilized practice-based immunization strategies are needed.
[h=4]KEYWORDS:[/h] immunization delivery; influenza; physician communication; vaccination
PMID: 31325130 DOI: 10.1007/s11606-019-05164-7