Hoffmann Kathryn, van Bijnen Evelien Me, George Aaron, Kutalek Ruth, Jirovsky Elena, Wojczewski Silvia, Maier Manfred
Department of General Practice and Family Medicine, Centre for Public Health, Medical University of Vienna, Kinderspitalgasse 15/1st floor, 1090, Vienna, Austria.
Netherlands Institute for Health Services Research (NIVEL), Utrecht, The Netherlands.
BMC Public Health. 2015 Sep 29;15:981. doi: 10.1186/s12889-015-2297-x.
This study aimed to identify associations between GP patient's knowledge about the spectrum of effectiveness of antibiotics and the probability of vaccination against influenza. The underlying hypothesis was that individuals with an understanding that antibiotics are ineffective against viruses, common colds, and flu were more likely to be vaccinated than persons lacking this knowledge.
This cross-sectional study was conducted within the context of the European APRES project in Austria. Between November 2010 and July 2011, patients were recruited from GP practices to complete questionnaires about their knowledge about antibiotics and their influenza vaccination status. Statistical analyses included subgroup analyses and logistic regression models.
Data of 3224 patients was analyzed, demonstrating that patients with better knowledge concerning antibiotics had a significantly higher likelihood of being vaccinated (OR 1.35, CI 95 % 1.18-1.54). While the overall vaccination rate was low (18.6 % in 2009/2010 and 14.0 % in 2010/2011), elderly compared to younger adults (OR 0.06 CI 95 % 0.03-0.13) and healthcare workers (OR 2.24, CI 95 % 1.42-3.54) demonstrated higher likelihood of vaccination. Additionally, female GPs had significantly more vaccinated patients than male GPs (OR 2.90, CI 95 % 1.32-6.40).
There has been little prior study on the association between a patient's knowledge of the effectiveness spectrum of antibiotics and influenza vaccination status. Given the public health imperative to increase annual prevalence of influenza vaccination, understanding this educational gap can improve specificity in counseling as well as vaccination rates. Ultimately, we found that those with a better knowledge on about antibiotics had a significantly higher likelihood of being vaccinated.
The results of this study demonstrate that vaccination prevalence is associated with patient's knowledge about antibiotics. It can be concluded that one strategy to improve the overall low vaccination rates for seasonal influenza in Austria would be, particularly for male GPs, to have a specific discussion with patients about these circumstances by focusing on younger patients. Further, public health efforts could supplement in-office strategies to improve this area of health literacy.
本研究旨在确定全科医生（GP）的患者对抗生素疗效范围的了解与流感疫苗接种概率之间的关联。潜在假设是，了解抗生素对病毒、普通感冒和流感无效的个体比缺乏此知识的个体更有可能接种疫苗。
这项横断面研究是在奥地利的欧洲APRES项目背景下进行的。2010年11月至2011年7月期间，从全科医生诊所招募患者，以完成关于他们对抗生素的了解以及流感疫苗接种状况的问卷调查。统计分析包括亚组分析和逻辑回归模型。
对3224名患者的数据进行了分析，结果表明，对抗生素了解较好的患者接种疫苗的可能性显著更高（比值比[OR]为1.35，95%置信区间[CI]为1.18 - 1.54）。虽然总体疫苗接种率较低（2009/2010年为18.6%，2010/2011年为14.0%），但与年轻人相比，老年人（OR为0.06，95%CI为0.03 - 0.13）和医护人员（OR为2.24，95%CI为1.42 - 3.54）接种疫苗的可能性更高。此外，女全科医生的接种患者明显多于男全科医生（OR为2.90，95%CI为1.32 - 6.40）。
此前关于患者对抗生素疗效范围的了解与流感疫苗接种状况之间的关联研究较少。鉴于提高年度流感疫苗接种率的公共卫生紧迫性，了解这一教育差距可以提高咨询的针对性以及疫苗接种率。最终，我们发现对抗生素了解较好的人接种疫苗的可能性显著更高。
本研究结果表明，疫苗接种率与患者对抗生素的了解有关。可以得出结论，提高奥地利季节性流感总体低疫苗接种率的一种策略是，特别是对于男全科医生，通过关注年轻患者，与患者就这些情况进行具体讨论。此外，公共卫生努力可以补充诊所内的策略，以提高这方面的健康素养。
