Wilcox Christopher R, Little Paul, Jones Christine E
NIHR Clinical Research Facility, University Hospital Southampton NHS Foundation Trust, Southampton.
Department of Primary Care and Population Sciences, Aldermoor Health Centre, University of Southampton, Southampton.
Br J Gen Pract. 2020 Jan 30;70(691):e179-e185. doi: 10.3399/bjgp20X708113. Print 2020 Feb.
Antenatal vaccines are commonly delivered in primary care, yet the views of GPs regarding these programmes have been neglected in research to date.
To establish the attitudes and current practice of GPs towards antenatal vaccination and their views on the optimal location for delivery of this service.
A multicentre online survey questionnaire.
A questionnaire was sent to GPs across England between December 2018 and January 2019.
The majority of 1586 responders considered antenatal vaccination safe (96% for influenza, 89% pertussis). GPs were significantly less confident in their knowledge of pertussis compared with influenza vaccination (64% versus 80% were confident, <0.001), and many desired further education (59% versus 48%, <0.001). Few (37%) discussed vaccination with pregnant women regularly, but most (80%) felt their recommendation would influence decision making. Those with greater confidence in their knowledge of pertussis and influenza vaccination, and who were >2 years since qualifying, discussed vaccination significantly more often (odds ratio [OR] 3.52, <0.001; OR 2.34, = 0.001; OR 1.76, = 0.003, respectively), regardless of whether they routinely saw pregnant women. Most (83%) reported that antenatal vaccination was GP led in their region, yet only 26% thought it should be primarily GP based. GPs expressed disconnect from antenatal care, and many suggested that midwives and/or secondary care should take greater responsibility for the delivery of antenatal vaccination.
There is support among GPs to embed vaccination programmes within routine antenatal care. Further educational resources, specifically designed for the needs of GPs, are needed to facilitate opportunistic discussion with pregnant women about vaccination.
产前疫苗通常在初级医疗保健机构接种，但迄今为止，全科医生（GP）对这些项目的看法在研究中一直被忽视。
确定全科医生对产前疫苗接种的态度和当前做法，以及他们对该服务最佳提供地点的看法。
一项多中心在线调查问卷。
2018年12月至2019年1月期间，向英格兰各地的全科医生发送了一份问卷。
1586名受访者中的大多数认为产前疫苗接种是安全的（流感疫苗为96%，百日咳疫苗为89%）。与流感疫苗接种相比，全科医生对百日咳疫苗知识的信心明显较低（有信心的比例分别为64%和80%，P<0.001），许多人希望接受进一步教育（分别为59%和48%，P<0.001）。很少有全科医生（37%）定期与孕妇讨论疫苗接种，但大多数（80%）认为他们的建议会影响决策。对百日咳和流感疫苗接种知识更有信心且取得资格超过2年的全科医生，无论是否经常接待孕妇，讨论疫苗接种的频率都明显更高（优势比分别为3.52，P<0.001；2.34，P = 0.001；1.76，P = 0.003）。大多数（83%）报告称，他们所在地区的产前疫苗接种由全科医生主导，但只有26%的人认为应以全科医生为主。全科医生表示与产前护理脱节，许多人建议助产士和/或二级医疗保健机构应在产前疫苗接种方面承担更大责任。
全科医生支持将疫苗接种项目纳入常规产前护理。需要专门针对全科医生需求设计的进一步教育资源，以促进与孕妇就疫苗接种进行机会性讨论。
