Adult and Child Consortium for Health Outcomes Research and Delivery Science, University of Colorado Anschutz Medical Campus and Children's Hospital Colorado, Aurora, Colorado, USA.
Division of General Internal Medicine, Denver Health, Denver, Colorado, USA.
J Am Geriatr Soc. 2021 Sep;69(9):2612-2618. doi: 10.1111/jgs.17274. Epub 2021 May 14.
In June 2019, the Advisory Committee on Immunization Practices recommended discontinuing the routine use of the pneumococcal conjugate vaccine (PCV13) among adults aged ≥65 years and instead recommended PCV13 be used based on shared clinical decision making (SCDM).
We wanted to assess among primary care physicians (1) knowledge and attitudes regarding the new SCDM PCV13 recommendation and (2) how the new recommendation will affect their likelihood of recommending PCV13 to adults aged ≥65 years.
This was done by mail and internet-based survey, which was conducted October 2019 through January 2020. The study was carried out on a nationally representative sample of general internists (GIMs) and family physicians (FPs).
The response rate was 64% (617/968, GIM 57%, FP 71%). Only 41% of respondents were aware of the SCDM PCV13 recommendation in adults aged ≥65 years; 76% agreed (37% "Strongly," 39% "Somewhat") that their patients aged ≥65 years will get confused by having a SCDM recommendation for PCV13 and a routine recommendation for the pneumococcal polysaccharide vaccine (PPSV23); 60% agreed (18% "Strongly," 42% "Somewhat") that they were unsure of what points to emphasize when having a SCDM conversation with an adult aged ≥65 years about receiving PCV13. Just over 50% reported they would be less likely to recommend PCV13 for adults aged ≥65 years as a result of the new recommendation, but 42% reported that their recommendation for PCV13 would not change.
Word of the new ACIP recommendation for PCV13 for adults aged ≥65 years needs to be further disseminated. Investigation into why some physicians do not plan to change their recommendations is warranted.
2019 年 6 月,免疫实践咨询委员会建议停止对 65 岁以上成年人常规使用肺炎球菌结合疫苗(PCV13),转而建议根据共同临床决策(SCDM)使用 PCV13。
我们希望评估初级保健医生(1)对新的 SCDM PCV13 推荐的知识和态度,以及(2)新建议将如何影响他们向 65 岁以上成年人推荐 PCV13 的可能性。
这是通过邮件和互联网调查完成的,调查于 2019 年 10 月至 2020 年 1 月进行。该研究在全国代表性的普通内科医生(GIM)和家庭医生(FP)样本中进行。
回复率为 64%(617/968,GIM 为 57%,FP 为 71%)。只有 41%的受访者知道 65 岁以上成年人的 SCDM PCV13 推荐;76%的人同意(37%“强烈同意”,39%“有些同意”),他们的 65 岁以上患者会因为对 PCV13 的 SCDM 推荐和对肺炎球菌多糖疫苗(PPSV23)的常规推荐而感到困惑;60%的人同意(18%“强烈同意”,42%“有些同意”),他们不确定在与 65 岁以上成年人进行 SCDM 对话时强调哪些要点;略多于 50%的人报告说,由于新建议,他们不太可能为 65 岁以上成年人推荐 PCV13,但 42%的人报告说,他们对 PCV13 的推荐不会改变。
需要进一步传播新的 ACIP 关于 65 岁以上成年人 PCV13 的推荐建议。值得调查一些医生为何不打算改变他们的建议。