Elkin Zachary P, Cohen Elisabeth J, Goldberg Judith D, Li Xiaochun, Castano Eliana, Gillespie Colleen, Haberman Ilyse, Jung Jesse J, Zabar Sondra, Park Lisa, Perskin Michael H
Department of Ophthalmology (Z.P.E., E.J.C., E.C., I.H., J.J.J., L.P.), Division of Biostatistics and Department of Population Health (J.D.G., X.L., M.H.P.), and Division of General Internal Medicine and Department of Medicine (C.G., S.Z.), New York University School of Medicine, New York, NY.
Eye Contact Lens. 2014 Jul;40(4):225-31. doi: 10.1097/ICL.0000000000000041.
In 2011, 15.8% of eligible patients in the United States were vaccinated against herpes zoster (HZ). To increase the usage of the HZ vaccine by studying physicians' knowledge, attitudes, practices, and perceived obstacles after interventions to overcome barriers.
General internal medicine physicians were surveyed with a cross-sectional internet survey from October to December 2011 before interventions to increase the use of the HZ vaccine and 1 year later. Interventions included education, increasing availability at the medical center pharmacy, and electronic medical record reminders. Outcome measures included changes in knowledge, attitudes, and practices, and perceived barriers. McNemar chi-square tests were used to compare the changes from the baseline survey for physicians who completed the follow-up survey.
Response rate for the baseline study was 33.5% (89/266) and for the follow-up was 29.8% (75/252). Fifty-five completed both surveys. There was a decrease from 57% at baseline to 40% at follow-up in the proportion of physicians who reported that less than 10% of their patients were vaccinated. They were more likely to know the HZ annual incidence (30% baseline; 70% follow-up; P=0.02), and report having educational information for physicians (7% baseline; 27% follow-up; P=0.003). The top helpful intervention was nursing administration of the vaccine. Average monthly HZ vaccine usage in the affiliated outpatient pharmacy increased in 10 months between surveys by 156% compared with the 3 months before the baseline survey.
Interventions implemented during the study led to an increase in physicians' basic knowledge of the HZ vaccine and an increase in usage at the affiliated pharmacy.
2011年，美国15.8%符合条件的患者接种了带状疱疹（HZ）疫苗。通过研究医生在克服障碍的干预措施后的知识、态度、行为及感知到的障碍，以提高HZ疫苗的使用率。
在2011年10月至12月进行增加HZ疫苗使用的干预措施之前及1年后，采用横断面网络调查对普通内科医生进行了调查。干预措施包括教育、增加医疗中心药房的可及性以及电子病历提醒。结果指标包括知识、态度和行为的变化以及感知到的障碍。使用McNemar卡方检验比较完成随访调查的医生与基线调查的变化情况。
基线研究的应答率为33.5%（89/266），随访应答率为29.8%（75/252）。55名医生完成了两项调查。报告称其患者中接种疫苗的比例不到10%的医生比例从基线时的57%降至随访时的40%。他们更有可能知晓HZ的年发病率（基线时为30%；随访时为70%；P = 0.02），并报告有针对医生的教育信息（基线时为7%；随访时为27%；P = 0.003）。最有帮助的干预措施是护士进行疫苗接种管理。在两次调查之间的10个月里，附属门诊药房的HZ疫苗月平均使用量比基线调查前3个月增加了156%。
研究期间实施的干预措施使医生对HZ疫苗的基本知识有所增加，附属药房的疫苗使用率也有所提高。
