Health Outcomes and Policy Research, Department of Clinical Pharmacy, University of Tennessee College of Pharmacy, 881 Madison Avenue, Memphis, TN 38163, USA.
Res Social Adm Pharm. 2014 Jan-Feb;10(1):126-40. doi: 10.1016/j.sapharm.2013.04.011. Epub 2013 May 23.
Since 2009, pharmacists in all 50 states in the U.S. have been authorized to administer vaccinations.
This study examined racial and ethnic disparities in the reported receipt of influenza vaccinations within the past year among noninstitutionalized community pharmacy patients and non-community pharmacy respondents.
The 2009 Medical Expenditure Panel Survey was analyzed. The sample consisted of respondents aged 50 years or older, as per the 2009 recommendations by the Advisory Committee on Immunization Practices. Bivariate and multivariate logistic regression analyses were conducted to examine the influenza vaccination rates and disparities in receiving influenza vaccinations within past year between non-Hispanic Whites (Whites), non-Hispanic Blacks (Blacks) and Hispanics. The influenza vaccination rates between community pharmacy patients and non-community pharmacy respondents were also examined.
Bivariate analyses found that among the community pharmacy patients, a greater proportion of Whites reported receiving influenza vaccinations compared to Blacks (60.9% vs. 49.1%; P < 0.0001) and Hispanics (60.9% vs. 51.7%; P < 0.0001). Among non-community pharmacy respondents, differences also were observed in reported influenza vaccination rates among Whites compared to Blacks (41.0% vs. 24.3%; P < 0.0001) and Hispanics (41.0% vs. 26.0%; P < 0.0001). Adjusted logistic regression analyses found significant racial disparities between Blacks and Whites in receiving influenza vaccinations within the past year among both community pharmacy patients (odds ratio [OR]: 0.81; 95% CI: 0.69-0.95) and non-community pharmacy respondents (OR: 0.66; 95% CI: 0.46-0.94). Sociodemographic characteristics and health status accounted for the disparities between Hispanics and Whites. Overall, community pharmacy patients reported higher influenza vaccination rates compared to non-community pharmacy respondents (59.0% vs. 37.2%; P < 0.0001).
Although influenza vaccination rates were higher among community pharmacy patients, there were racial disparities in receiving influenza vaccinations among both community pharmacy patients and non-community pharmacy respondents. Increased emphasis on educational campaigns among pharmacists and their patients, especially minorities, may be needed.
自 2009 年以来,美国 50 个州的药剂师都被授权接种疫苗。
本研究旨在调查过去一年中,在非住院社区药房患者和非社区药房受访者中,报告接种流感疫苗的情况是否存在种族和民族差异。
对 2009 年医疗支出面板调查进行了分析。样本由年龄在 50 岁或以上的受访者组成,这是根据免疫实践咨询委员会 2009 年的建议。采用二变量和多变量逻辑回归分析,调查非西班牙裔白人(白人)、非西班牙裔黑人(黑人)和西班牙裔之间过去一年中流感疫苗接种率和接种率的差异。还调查了社区药房患者和非社区药房受访者之间的流感疫苗接种率。
在社区药房患者中,二变量分析发现,与黑人(60.9%比 49.1%;P<0.0001)和西班牙裔(60.9%比 51.7%;P<0.0001)相比,更多的白人报告接种了流感疫苗。在非社区药房受访者中,白人与黑人(41.0%比 24.3%;P<0.0001)和西班牙裔(41.0%比 26.0%;P<0.0001)之间也存在报告的流感疫苗接种率差异。调整后的逻辑回归分析发现,在过去一年中,无论是在社区药房患者(比值比[OR]:0.81;95%置信区间[CI]:0.69-0.95)还是非社区药房受访者(OR:0.66;95%CI:0.46-0.94)中,黑人和白人之间都存在显著的种族差异。社会人口特征和健康状况解释了西班牙裔和白人之间的差异。总体而言,社区药房患者报告的流感疫苗接种率高于非社区药房受访者(59.0%比 37.2%;P<0.0001)。
尽管社区药房患者的流感疫苗接种率较高,但在社区药房患者和非社区药房受访者中,接种流感疫苗的情况存在种族差异。可能需要加强药剂师及其患者(尤其是少数族裔)的教育宣传活动。