Archive for February 3, 2018

Primary Care Physicians’ Struggle with Current Adult Pneumococcal Vaccine Recommendations

Journal of American Board of Family Medicine January-February 2018 V.31 N.1 P.94-104

Laura P. Hurley, MD, MPH, Mandy A. Allison, MD, MSPH, Tamara Pilishvili, MPH, Sean T. O’Leary, MD, MPH, Lori A. Crane, PhD, MPH, Michaela Brtnikova, PhD, MPH, Brenda L. Beaty, MSPH, Megan C. Lindley, MPH, Carolyn B. Bridges, MD and Allison Kempe, MD, MPH

From the Adult and Child Consortium for Health Outcomes Research and Delivery Science, University of Colorado Anschutz Medical Campus and Children’s Hospital Colorado, Aurora (LPH, MAA, STO, LAC, MB, BLB, AK); the Division of General Internal Medicine, Denver Health, Denver, CO (LPH); the National Center for Immunization and Respiratory Diseases, Centers for Disease Control and Prevention, Atlanta, GA (TP, MCL, CBB); and the Departments of Pediatrics (MAA, STO, MB, AK) and Community and Behavioral Health (LAC), University of Colorado Anschutz Medical Campus, Aurora.

Introduction:

In 2012, the Advisory Committee on Immunization Practices recommended 13-valent pneumococcal conjugate vaccine (PCV13) in series with 23-valent pneumococcal polysaccharide vaccine (PPSV23) for at-risk adults ≥19; in 2014, it expanded this recommendation to adults ≥65. Primary care physicians’ practice, knowledge, attitudes, and beliefs regarding these recommendations are unknown.

Methods:

Primary care physicians throughout the U.S. were surveyed by E-mail and post from December 2015 to January 2016.

Results:

Response rate was 66% (617 of 935). Over 95% of respondents reported routinely assessing adults’ vaccination status and recommending both vaccines. A majority found the current recommendations to be clear (50% “very clear,” 38% “somewhat clear”). Twenty percent found the upfront cost of purchasing PCV13, lack of insurance coverage, inadequate reimbursement, and difficulty determining vaccination history to be “major barriers” to giving these vaccines. Knowledge of recommendations varied, with 83% identifying the PCV13 recommendation for adults ≥65 and only 21% identifying the recommended interval between PCV13 and PPSV23 in an individual <65 at increased risk.

Conclusions:

Almost all surveyed physicians reported recommending both pneumococcal vaccines, but a disconnect seems to exist between perceived clarity and knowledge of the recommendations. Optimal implementation of these recommendations will require addressing knowledge gaps and reported barriers.

abstract

http://www.jabfm.org/content/31/1/94

PDF

http://www.jabfm.org/content/31/1/94.full.pdf+html

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February 3, 2018 at 8:59 am


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