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内分泌科住院对糖尿病患者疫苗接种覆盖率的影响:一项真实研究。

Impact of Hospitalization in an Endocrinology Department on Vaccination Coverage in People Living with Diabetes: A Real-Life Study.

机构信息

Clinical Pharmacy Department, CHU Montpellier, University of Montpellier, 34295 Montpellier, France.

Phymedexp, University of Montpellier, INSERM, CNRS, CHRU de Montpellier, 34295 Montpellier, France.

出版信息

Medicina (Kaunas). 2022 Feb 1;58(2):219. doi: 10.3390/medicina58020219.

Abstract

: Vaccination coverage is suboptimal in people living with diabetes. The objectives of this study were to determine the impact of hospitalization on vaccination coverage and the variables associated with vaccination during hospital stay. : This observational study was conducted from May 2019 to December 2019 in the Endocrinology-Nutrition-Diabetes Department of the University Hospital of Montpellier, France. This department encompasses three medical units, two of which have a full-time clinical pharmacist involved in the multidisciplinary management of patients. All adult diabetic patients who completed a questionnaire about vaccines were prospectively included by a clinical pharmacist and followed until department discharge. Coverage at the time of admission for the tetanus, diphtheria, pertussis (Tdap), pneumococcal, influenza, and herpes zoster vaccines was assessed from patient interviews and/or contact with the general practitioner and/or with the community pharmacist. Multivariable logistic regression analysis was performed to identify the factors associated with a vaccination update during the hospital stay. : A total of 222 patients were included (mean age: 59.4 years, 68.5% type 2 diabetes). Vaccination coverage increased by 26.7% (47.3% to 59.9%), 188.0% (10.8% to 31.1%) and 8.9% (45.9% to 50.0%), respectively, for the Tdap, pneumococcal and influenza vaccines during hospital stay. Female sex, admission to a diabetes care unit with a full-time pharmacist, favorable feelings about vaccination, unknown immunization coverage for pneumococcal vaccines, and evaluation and recording of vaccine coverage at admission in the patient medical records were associated with at least one vaccination during hospital stay. : Our real-life study highlights that hospitalization and multidisciplinary management (i.e., physician-pharmacist) may be key points in the diabetes care pathway to improve vaccination coverage, especially for patients with advanced diabetes and comorbidities.

摘要

疫苗接种覆盖率在糖尿病患者中不理想。本研究的目的是确定住院对疫苗接种覆盖率的影响,以及与住院期间接种疫苗相关的变量。

这项观察性研究于 2019 年 5 月至 12 月在法国蒙彼利埃大学医院的内分泌、营养和糖尿病科进行。该部门包括三个医疗单位,其中两个单位有全职临床药剂师参与患者的多学科管理。所有完成疫苗问卷的成年糖尿病患者均由临床药剂师前瞻性纳入,并随访至科室出院。通过与患者访谈和/或与全科医生和/或社区药剂师联系,评估入院时破伤风、白喉、百日咳(Tdap)、肺炎球菌、流感和带状疱疹疫苗的接种率。采用多变量逻辑回归分析确定与住院期间更新疫苗接种相关的因素。

共纳入 222 例患者(平均年龄:59.4 岁,68.5%为 2 型糖尿病)。住院期间 Tdap、肺炎球菌和流感疫苗的接种率分别增加了 26.7%(47.3%至 59.9%)、188.0%(10.8%至 31.1%)和 8.9%(45.9%至 50.0%)。女性、入住有全职药剂师的糖尿病护理病房、对疫苗接种有好感、肺炎球菌疫苗免疫接种情况未知、以及在患者病历中评估和记录疫苗接种情况,与住院期间至少接种一次疫苗相关。

我们的真实生活研究强调,住院和多学科管理(即医生-药剂师)可能是改善疫苗接种覆盖率的糖尿病治疗途径中的关键要点,尤其是对于患有晚期糖尿病和合并症的患者。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/7fa2/8879927/fca1a84b7b2b/medicina-58-00219-g001.jpg

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