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全科医生参与成人疫苗接种实践的有效性:一项对国际证据的系统评价和荟萃分析

Effectiveness of General Practitioners' Involvement in Adult Vaccination Practices: A Systematic Review and Meta-Analysis of International Evidence.

作者信息

Ceccarelli Andrea, Munafò Gabriele, Sintoni Francesco, Cintori Christian, Gori Davide, Montalti Marco

机构信息

Unit of Hygiene and Medical Statistics, Department of Biomedical and Neuromotor Sciences, University of Bologna, 40126 Bologna, Italy.

Forlì and Rubicone Health District, Romagna Local Health Authority, 47522 Cesena, Italy.

出版信息

Vaccines (Basel). 2024 Dec 20;12(12):1438. doi: 10.3390/vaccines12121438.

Abstract

BACKGROUND

General practitioners (GPs) and primary care units collaborate with Prevention Departments (PDs) to improve immunization by participating in vaccination campaigns, sharing tools, and implementing educational programs to raise patient awareness. This review aimed to identify effective strategies for involving GPs in PD vaccination practices.

METHODS

A systematic review following PRISMA guidelines was conducted on MEDLINE, TripDatabase, ClinicalTrials, CINAHL, and Cochrane up to January 2024 to identify full-text studies in English evaluating the effectiveness of GP involvement. A meta-analysis was also performed.

RESULTS

Of 1018 records, 15 studies were included, with an intermediate quality assessment. Studies originated from the United States ( = 9), Europe (5), Singapore (1), and China (1). Eight studies investigated educational programs for GPs, while seven focused on organizational or technological interventions to enhance immunization practices. Twelve studies reported increased vaccine uptake after intervention. Vaccines addressed included influenza, SARS-CoV-2, pneumococcal, zoster, and trivalent (diphtheria, tetanus, pertussis). Interventions involving GPs in PD vaccination campaigns, focusing on organizational or technological strategies, demonstrated a significant increase in vaccine uptake (OR = 1.15; 95% CI: 1.03-1.27; < 0.0001; I = 96%).

CONCLUSIONS

GPs emerged as valuable allies for PDs due to their extensive territorial reach and trusted relationships with patients. Additionally, up-to-date organizational and technological tools could play a decisive role in increasing vaccine uptakes. This study, offering valuable insights into the effectiveness of GPs involvement, may be useful to implement similar intervention in different contexts.

摘要

背景

全科医生(GPs)和基层医疗单位与预防部门(PDs)合作,通过参与疫苗接种活动、共享工具以及实施教育项目来提高患者意识,从而改善免疫接种情况。本综述旨在确定让全科医生参与预防部门疫苗接种工作的有效策略。

方法

按照PRISMA指南,截至2024年1月,在MEDLINE、TripDatabase、ClinicalTrials、CINAHL和Cochrane数据库上进行了系统综述,以识别评估全科医生参与有效性的英文全文研究。还进行了荟萃分析。

结果

在1018条记录中,纳入了15项研究,并进行了中等质量评估。研究来自美国(9项)、欧洲(5项)、新加坡(1项)和中国(1项)。八项研究调查了针对全科医生的教育项目,而七项研究侧重于组织或技术干预措施以加强免疫接种工作。十二项研究报告称干预后疫苗接种率有所提高。涉及的疫苗包括流感疫苗、SARS-CoV-2疫苗、肺炎球菌疫苗、带状疱疹疫苗和三联疫苗(白喉、破伤风、百日咳)。让全科医生参与预防部门疫苗接种活动,侧重于组织或技术策略的干预措施,显示疫苗接种率显著提高(OR = 1.15;95% CI:1.03 - 1.27;P < 0.0001;I² = 96%)。

结论

由于全科医生广泛的地域覆盖范围以及与患者之间值得信赖的关系,他们成为预防部门的重要盟友。此外,最新的组织和技术工具在提高疫苗接种率方面可能发挥决定性作用。本研究为全科医生参与的有效性提供了有价值的见解,可能有助于在不同背景下实施类似干预措施。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/b7ad/11680296/8736b32e6103/vaccines-12-01438-g001.jpg

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