מתוך medicontext.co.il
NEW YORK (Reuters Health) – Many US physicians do not recommend strongly enough that elderly people and other high-risk individuals receive influenza and pneumococcal vaccinations, according to a report in the Archives of Internal Medicine for December 10.
Both generalists and subspecialists are missing many opportunities to promote immunization for their patients, Dr. Kristin L. Nichol from the Veterans Administration Medical Center, Minneapolis, Minnesota, told Reuters Health. Sometimes they fail to recommend immunization, she said, but most often they have not implemented strategies that are known to be effective in increasing the immunization rate.
Dr. Nichol and colleagues surveyed a random nationwide sample of family physicians, general internists, and internal medicine subspecialists, of whom 1874 responded. The majority of the respondents indicated that it is very important that their high-risk patients have current influenza and pneumococcal vaccinations.
However, only 86% of the generalists and 75% of the subspecialists said that they "very strongly" recommend influenza vaccinations to their elderly patients (p < 0.001). Only 81% of the generalists and 64% of the subspecialists said they very strongly recommend pneumococcal vaccinations (p < 0.001), Dr. Nichol's group found.
Fewer than 30% of the physicians surveyed used calls or mailings to patients or other systems to remind themselves and their patients about getting vaccinations.
Generalists and subspecialists should take advantage of every opportunity with their patients to talk with them about immunizations and strongly recommend them, Dr. Nichol said.
"Physicians are humans and they frequently forget, so we recommend that systems be designed and implemented to remind patients and physicians about vaccinations. These can include having standing orders and allowing nurses to offer and administer vaccinations," Dr. Nichol advised.
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