Young Jennifer L, Bernheim Ruth G, Korte Jeffrey E, Stoler Mark H, Guterbock Thomas M, Rice Laurel W
Division of Gynecologic Oncology, Department of Obstetrics and Gynecology, Medical University of South Carolina, Charleston, SC, USA.
J Pediatr Adolesc Gynecol. 2011 Dec;24(6):380-5. doi: 10.1016/j.jpag.2011.06.016. Epub 2011 Sep 9.
Concerns have been raised about gynecologists as vaccinators. This survey evaluated use of the human papillomavirus (HPV) vaccine, attitudes, and barriers among gynecologists and family practitioners for differences between the 2 specialties.
A cross-sectional survey was conducted using a 50-item, self-administered questionnaire mailed to participants.
The study was conducted in Virginia through the University of Virginia Center for Survey Research.
The questionnaire was mailed to 500 family practitioners and 500 gynecologists.
The questionnaire asked provider and practice demographics, vaccine practices, knowledge, HPV vaccine attitudes, and barriers to vaccination.
We compared gynecologists to family practitioners for the outcome of offering HPV vaccination. Logistic regression was performed to determine factors associated with providers choosing to offer and recommend the HPV vaccine.
After exclusion of ineligible physicians, 385 of 790 doctors responded (48.7%). Seventy percent of family practitioners and 73.5% of gynecologists currently offer the HPV vaccine. There were no significant differences in demographics or practice patterns between the specialties. The most frequent barrier to vaccination reported by both groups was reimbursement. In multivariate logistic regression, inadequate reimbursement was negatively associated with offering the HPV vaccine (odds ratio [OR] 0.41; 95% confidence interval [CI] 0.15-1.1) and with recommending the vaccine to patients (OR 0.45; 95% CI 0.26-0.76). Experience treating HPV- related disease was positively associated with offering the HPV vaccine (OR 2.3; 95% CI 1.1-4.8).
Gynecologists are providing HPV vaccination at rates similar to family practitioners. Reimbursement concerns may negatively have an impact on doctors' recommendation of the HPV vaccine.
人们对妇科医生作为疫苗接种者存在担忧。本调查评估了妇科医生和家庭医生对人乳头瘤病毒（HPV）疫苗的使用情况、态度及障碍，以比较这两个专业之间的差异。
采用一份包含50个条目的自填式问卷进行横断面调查，并邮寄给参与者。
该研究通过弗吉尼亚大学调查研究中心在弗吉尼亚州开展。
问卷被邮寄给500名家庭医生和500名妇科医生。
问卷询问了提供者和执业机构的人口统计学信息、疫苗接种实践、知识、对HPV疫苗的态度以及疫苗接种的障碍。
我们比较了妇科医生和家庭医生提供HPV疫苗接种的情况。进行逻辑回归分析以确定与提供者选择提供和推荐HPV疫苗相关的因素。
在排除不合格医生后，790名医生中有385名做出了回应（48.7%）。目前，70%的家庭医生和73.5%的妇科医生提供HPV疫苗。两个专业在人口统计学或执业模式方面没有显著差异。两组报告的最常见疫苗接种障碍是报销问题。在多变量逻辑回归中，报销不足与提供HPV疫苗呈负相关（优势比[OR]为0.41；95%置信区间[CI]为0.15 - 1.1），与向患者推荐该疫苗也呈负相关（OR为0.45；95%CI为0.26 - 0.76）。治疗HPV相关疾病的经验与提供HPV疫苗呈正相关（OR为2.3；95%CI为1.1 - 4.8）。
妇科医生提供HPV疫苗接种的比例与家庭医生相似。对报销的担忧可能会对医生推荐HPV疫苗产生负面影响。
