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BMC Primary Care
Published in: BMC Primary Care 1/2016

Open Access 01-12-2016 | Research article

Advising vaccinations for the elderly: a cross-sectional survey on differences between general practitioners and physician assistants in Germany

Authors: Carolina Judith Klett-Tammen, Gérard Krause, Thomas von Lengerke, Stefanie Castell

Published in: BMC Primary Care | Issue 1/2016

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Abstract

Background

In Germany, the coverage of officially recommended vaccinations for the elderly is below a desirable level. It is known that advice provided by General Practitioners and Physician Assistants influences the uptake in patients ≥60 years. Therefore, the predictors of advice-giving behavior by these professions should be investigated to develop recommendations for possible actions for improvement.

Methods

We conducted a postal cross-sectional survey on knowledge, attitudes and advice - giving behavior regarding vaccinations in the elderly among General Practitioners and Physician Assistants in 4995 practices in Germany. To find specific predictors, we performed logistic regressions with non-advising on any officially recommended vaccination or on three specific vaccinations as four separate outcomes, first using all participants, then only General Practitioners and lastly only Physician Assistants as our study population.

Results

Participants consisted of 774 General Practitioners and 563 Physician Assistants, of whom overall 21 % stated to have not advised an officially recommended vaccination in elderly patients. The most frequent explanation was having forgotten about it. The habit of not counselling on vaccinations at regular intervals was associated with not advising any vaccination (OR: 2.8), influenza vaccination (OR: 2.3), and pneumococcal vaccination (OR: 3.1). While more General Practitioners than Physician Assistants felt sufficiently informed (90 % vs. 79 %, p < 0.001), General Practitioners displayed higher odds to not advise specific vaccinations (ORs: 1.8–2.8).

Conclusions

To reduce the high risk of forgetting to advice on vaccinations, we recommend improving and promoting standing recall-systems, encouraging General Practitioners and Physician Assistants to counsel routinely at regular intervals regarding vaccinations, and providing Physician Assistants with better, tailor-made information on official recommendations and their changes.
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Literature
1.
Robert Koch Institute. Announcement of the Standing Committee on Vaccination at Robert Koch Institute (RKI). Recommendations of the Standing Committee on Vaccination (STIKO) at Robert Koch-Institute/Effective August 2015. Epidemiol Bull. 2015;34(10):327–360.
2.
3.
Reiter S, Rasch G. Federal Health Monitoring System: Vaccinations. In: Federal Health Monitoring System. vol. 1. Berlin: Robert Koch Institute and Federal Office of Statistics; 2004.
4.
5.
Poethko-Muller C, Schmitz R. Vaccination coverage in German adults: results of the German Health Interview and Examination Survey for Adults (DEGS1). Bundesgesundheitsblatt Gesundheitsforschung Gesundheitsschutz. 2013;56(5–6):845–57.CrossRefPubMed
6.
Robert Koch Institute. Coverage of measles-, HPV-, and influenza vaccination in Germany. Epidemiol Bull. 2016;1:1–7.
7.
World Health Organization. Evaluation of seasonal influenza vaccination policies and coverage in the WHO European Region. Results from the 2008/2009 and 2009/2010 influenza seasons. Based on a joint VENICE–ECDC–WHO survey. Kopenhagen: WHO Europe; 2014.
8.
Kyaw M, Nguyen-Van-Tam J, Pearson J. Family doctor advice is the main determinant of pneumococcal vaccine uptake. J Epidemiol Community Health. 1999;53:589–90.CrossRefPubMedPubMedCentral
9.
Schneeberg A, Bettinger JA, McNeil S, Ward BJ, Dionne M, Cooper C, Coleman B, Loeb M, Rubinstein E, McElhaney J, et al. Knowledge, attitudes, beliefs and behaviours of older adults about pneumococcal immunization, a Public Health Agency of Canada/Canadian Institutes of Health Research Influenza Research Network (PCIRN) investigation. BMC Public Health. 2014;14:442.CrossRefPubMedPubMedCentral
10.
Johnson D, Nichol K, Lipczynski K. Barriers to adult immunization. Am J Med. 2008;121(7 Suppl 2):S28–35.CrossRefPubMed
11.
12.
Robert Koch Institute. How do GPs and internists vaccinate? Results of a recent survey regarding attitudes and behavior. Epidemiol Bull. 2000;45:357–60.
13.
Nichol KL, Zimmermann R. Generalist and Subspecialist Physicians’ Knowledge, Attitudes, and Practices Regarding Influenza and Pneumococcal Vaccinations for Elderly and Other High-Risk Patients. Arch Intern Med. 2001;161:2702–8.CrossRefPubMed
14.
Ridda I, Lindley IR, Gao Z, McIntyre P, Macintyre CR. Differences in attitudes, beliefs and knowledge of hospital health care workers and community doctors to vaccination of older people. Vaccine. 2008;26(44):5633–40.CrossRefPubMed
15.
Porst R. Pretests for Evaluation of the questionnaire(−draft). In: Sahner H, Bayer M, Sackmann R, editors. Questionnaire. A Workbook. 4th ed. Wiesbaden: Springer VS; 2014. p. 189–205.
16.
Klose J, Rehbein I. Atlas of physicians 2015 - Data on density of panel physicians. In: Atlas of Physicians. Berlin: Scientific Institute of the AOK; 2015.
17.
18.
Employee in health service in 1000. Outline features: Year, Germany, Sex, Facility, Occupation. [www.​gbe-bund.​de]. (Retrieved: 25.07.2016).
19.
Destatis. Population and Occupation. Preliminary results of the population updateable on the basis of the Zensus 2011. Wiesbaden: The Federal Statistical Office (Destatis); 2015.
20.
Pielak KL, McIntyre CC, Tu AW, Remple VP, Halperin B, Buxton JA. Identifying attitudes, beliefs and reported practices of nurses and doctors as immunization providers. J Adv Nurs. 2010;66(7):1602–11.CrossRefPubMed
21.
22.
National-Association-of-Statutory-Health-Insurance-Physicians, National-Association-of-Statutory-Health-Insurance-Funds. Federal Master Treaty for Medical Practitioners, Enclosure 24. Dtsch Arztebl Int. 2013;110:A1757–60.
23.
Güthlin C, Beyer M, Erler A, Gensichen J, Hoffmann B, Mergenthal K, Müller V, Muth C, Petersen JJ, Gerlach FM. Recruitment of Family Practitioners for Research. Experiences from Five Studies. Z Allg Med. 2012;88(4):173–81.
24.
Nowalk MP, Zimmerman RK, Feghali J. Missed opportunities for adult immunization in diverse primary care office settings. Vaccine. 2004;22(25–26):3457–63.CrossRefPubMed
25.
26.
Hindringer B. Recall-Systems in physician practices. Diverse fields of application. PRAXiS Dtsch Arztebl. 2007:104(19):16–7.
27.
Prinz S, Rashid A. Online management of appointments. Many potentials for physician practices. PRAXiS Dtsch Arztebl. 2015:112(15):8–10.
28.
29.
30.
31.
Voelker R. Physicians’ Offices Play Key Role in Promoting Vaccination to Adult Patients. JAMA. 2012;307(6):552.CrossRefPubMed
Metadata
Title
Advising vaccinations for the elderly: a cross-sectional survey on differences between general practitioners and physician assistants in Germany
Authors
Carolina Judith Klett-Tammen
Gérard Krause
Thomas von Lengerke
Stefanie Castell
Publication date
01-12-2016
Publisher
BioMed Central
Published in
BMC Primary Care / Issue 1/2016
Electronic ISSN: 2731-4553
DOI
https://doi.org/10.1186/s12875-016-0502-3

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