Abstract
BackgroundIn 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.MethodsWe 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.ResultsParticipants 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).ConclusionsTo 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.Electronic supplementary materialThe online version of this article (doi:10.1186/s12875-016-0502-3) contains supplementary material, which is available to authorized users.
Highlights
In Germany, the coverage of officially recommended vaccinations for the elderly is below a desirable level
Vaccination coverage for pneumococcal vaccination (PV) in the elderly is as low as 31 % in Germany [5]; for influenza vaccination (IV), it is with 37 % clearly lower than the target of 75 % vaccination in the elderly [6], given by the World Health Organization [7]; while it is high for tetanus vaccination (TV) with 93 - 95 % [5]
Median age of general practitioners (GP) was 54 years (interquartile range (IQR): 48–61), median time working as GP was 17 years (IQR: 10–24), 47 % of the respondents were female and 77 % worked in the Western part of Germany
Summary
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. Recommendations of the German Standing Committee on Vaccination (STIKO) include influenza vaccination (IV), tetanus vaccination (TV) and pneumococcal vaccination (PV) for individuals who are 60 years or older [1]. While there is some basic evidence from the year 2000/2001 regarding knowledge, attitude, and practice (KAP) factors with respect to vaccinations in the elderly in German GP [12] and predictors for advising specific vaccines to individuals in this agegroup in American [13] and Australian [14] physicians, PA have been neglected in vaccination-related research in Germany so far. We conducted a survey in both professions in Germany and explored - within the KAP-framework - predictors for not giving vaccination advice to the elderly in general, and on TV, IV, and PV to gain insight into opportunities for profession specific improvement of advice-giving behavior
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