处方要求药剂师接种疫苗对带状疱疹疫苗接种率的影响。
The effect of a prescription order requirement for pharmacist-administered vaccination on herpes zoster vaccination rates.
机构信息
Department of Pharmacotherapy, College of Pharmacy, University of Utah, 30 South 2000 East, Salt Lake City, UT 84112, USA.
Department of Pharmacotherapy, College of Pharmacy, University of Utah, 30 South 2000 East, Salt Lake City, UT 84112, USA; Department of Health Promotion and Education, College of Health, University of Utah, 250 S 1850 E Rm 239, Salt Lake City, UT 84112, USA.
出版信息
Vaccine. 2019 Jan 21;37(4):631-636. doi: 10.1016/j.vaccine.2018.12.003. Epub 2018 Dec 15.
OBJECTIVE
To determine the effect of a prescription order requirement for pharmacist-administered zoster vaccination on zoster vaccination in adults aged 60+.
METHODS
A 50-state law review of statutes and regulations regarding pharmacists' ability to administer the zoster vaccine with/without a prescription order was performed. States were classified as prescription order required or not required as of January 1, 2014. Data on adults aged 60+ were obtained from the 2014 Behavioral Risk Factor Surveillance System (BRFSS). Chi-square tests and multilevel logistic regression models with and without propensity scores methods were used.
RESULTS
Of the 50 states, 39 and the District of Columbia did not require a prescription order. After propensity score matching, zoster vaccination rates for adults ages 60 and older were significantly higher in states that did not require a prescription order (23.0% vs 21.1%, p = 0.0022). The propensity score-matched multilevel logistic regression model for adults aged 60+ found modestly higher odds of HZ vaccination for states that removed the prescription order requirement (OR 1.17, 95% CI 1.01-1.35). Similar estimates were found across other methodologies employed and age strata, although statistical significance varied.
CONCLUSIONS
Prescription order requirements are associated with HZ vaccination rates. By removing a prescription order requirement, states may be able to promote increases in HZ vaccination in adults aged 60+.
目的
确定处方要求对 60 岁以上成年人带状疱疹疫苗接种的影响。
方法
对有关药剂师有无处方均可接种带状疱疹疫苗的能力的 50 个州的法规进行了审查。截至 2014 年 1 月 1 日，各州被归类为需要或不需要处方要求。从 2014 年行为风险因素监测系统（BRFSS）中获取了 60 岁以上成年人的数据。使用卡方检验和有无倾向评分方法的多水平逻辑回归模型进行分析。
结果
在 50 个州和哥伦比亚特区中，有 39 个州和哥伦比亚特区不需要处方要求。在进行倾向评分匹配后，不需要处方要求的州 60 岁及以上成年人的带状疱疹疫苗接种率明显更高（23.0%比 21.1%，p=0.0022）。针对 60 岁以上成年人的倾向评分匹配多水平逻辑回归模型发现，取消处方要求的州带状疱疹疫苗接种的可能性适度增加（OR 1.17，95%CI 1.01-1.35）。虽然统计学意义有所不同，但在使用的其他方法和年龄层中均发现了类似的估计值。
结论
处方要求与 HZ 疫苗接种率有关。通过取消处方要求，各州可能能够促进 60 岁以上成年人的 HZ 疫苗接种率的提高。
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