Abstract
OBJECTIVE: To assess influenza vaccination status and influenza vaccination practices of family physicians in Quebec. DESIGN: Mail survey of a random sample of 1000 family physicians. SETTING: Family practices in the province of Quebec. PARTICIPANTS: Of 1000 Quebec family physicians sent questionnaires, 550 responded. After excluding physicians who worked only in institutions, had no patients older than 65 years, or did clinical work less than 20% of the time, 379 respondents were eligible for the study. MAIN OUTCOME MEASURES: Vaccination status of family physicians in 1996 and professional practices based on six clinical and administrative activities pertaining to influenza vaccination. RESULTS: Prevalence of vaccination was 35.5% (95% confidence interval 30.8% to 40.4%) among responding physicians and was higher among those 60 years and older, those with a chronic condition, and those perceiving high peer pressure to get vaccinated. Most respondents frequently assessed the current influenza vaccination status of their patients, risk factors for influenza-related complications, and contraindications to the vaccine. They also frequently provided education about influenza and its vaccine, recommended vaccination, and administered the vaccine. Only a few reported assessing prior influenza vaccinations or recording vaccination status regularly. Finally, vaccinated physicians recommended the vaccine more frequently to their patients than unvaccinated physicians did. CONCLUSION: Promotion programs focusing on peer influence could increase vaccination of family physicians. This could in turn improve vaccination coverage of elderly patients.
Full Text
The Full Text of this article is available as a PDF (175.0 KB).
Selected References
These references are in PubMed. This may not be the complete list of references from this article.
- Buchner D. M., Carter W. B., Inui T. S. The relationship of attitude changes to compliance with influenza immunization. A prospective study. Med Care. 1985 Jun;23(6):771–779. doi: 10.1097/00005650-198506000-00002. [DOI] [PubMed] [Google Scholar]
- Carman W. F., Elder A. G., Wallace L. A., McAulay K., Walker A., Murray G. D., Stott D. J. Effects of influenza vaccination of health-care workers on mortality of elderly people in long-term care: a randomised controlled trial. Lancet. 2000 Jan 8;355(9198):93–97. doi: 10.1016/S0140-6736(99)05190-9. [DOI] [PubMed] [Google Scholar]
- Doebbeling B. N., Edmond M. B., Davis C. S., Woodin J. R., Zeitler R. R. Influenza vaccination of health care workers: evaluation of factors that are important in acceptance. Prev Med. 1997 Jan-Feb;26(1):68–77. doi: 10.1006/pmed.1996.9991. [DOI] [PubMed] [Google Scholar]
- Duclos P., Hatcher J. Epidemiology of influenza vaccination in Canada. Can J Public Health. 1993 Sep-Oct;84(5):311–315. [PubMed] [Google Scholar]
- Eisenberg J. M. Physician utilization. The state of research about physicians' practice patterns. Med Care. 1985 May;23(5):461–483. [PubMed] [Google Scholar]
- Evans M. E., Hall K. L., Berry S. E. Influenza control in acute care hospitals. Am J Infect Control. 1997 Aug;25(4):357–362. doi: 10.1016/s0196-6553(97)90029-8. [DOI] [PubMed] [Google Scholar]
- Fedson D. S. Influenza vaccination of medical residents at the University of Virginia: 1986 to 1994. Infect Control Hosp Epidemiol. 1996 Jul;17(7):431–433. doi: 10.1086/647336. [DOI] [PubMed] [Google Scholar]
- Fiebach N. H., Viscoli C. M. Patient acceptance of influenza vaccination. Am J Med. 1991 Oct;91(4):393–400. doi: 10.1016/0002-9343(91)90157-s. [DOI] [PubMed] [Google Scholar]
- Heimberger T., Chang H. G., Shaikh M., Crotty L., Morse D., Birkhead G. Knowledge and attitudes of healthcare workers about influenza: why are they not getting vaccinated? Infect Control Hosp Epidemiol. 1995 Jul;16(7):412–415. doi: 10.1086/647139. [DOI] [PubMed] [Google Scholar]
- Johns M. B., Hovell M. F., Ganiats T., Peddecord K. M., Agras W. S. Primary care and health promotion: a model for preventive medicine. Am J Prev Med. 1987 Nov-Dec;3(6):346–357. [PubMed] [Google Scholar]
- Kuller L. H., Lave J. R. Decrease in the overall costs of the Medicare program. Am J Prev Med. 1988 Jan-Feb;4(1):59–60. [PubMed] [Google Scholar]
- McArthur M. A., Simor A. E., Campbell B., McGeer A. Influenza and pneumococcal vaccination and tuberculin skin testing programs in long-term care facilities: where do we stand? Infect Control Hosp Epidemiol. 1995 Jan;16(1):18–24. doi: 10.1086/646997. [DOI] [PubMed] [Google Scholar]
- McPhee S. J., Bird J. A. Implementation of cancer prevention guidelines in clinical practice. J Gen Intern Med. 1990 Sep-Oct;5(5 Suppl):S116–S122. doi: 10.1007/BF02600856. [DOI] [PubMed] [Google Scholar]
- Montaño D. E., Phillips W. R. Cancer screening by primary care physicians: a comparison of rates obtained from physician self-report, patient survey, and chart audit. Am J Public Health. 1995 Jun;85(6):795–800. doi: 10.2105/ajph.85.6.795. [DOI] [PMC free article] [PubMed] [Google Scholar]
- Nichol K. L., Hauge M. Influenza vaccination of healthcare workers. Infect Control Hosp Epidemiol. 1997 Mar;18(3):189–194. doi: 10.1086/647585. [DOI] [PubMed] [Google Scholar]
- Nichol K. L., Lind A., Margolis K. L., Murdoch M., McFadden R., Hauge M., Magnan S., Drake M. The effectiveness of vaccination against influenza in healthy, working adults. N Engl J Med. 1995 Oct 5;333(14):889–893. doi: 10.1056/NEJM199510053331401. [DOI] [PubMed] [Google Scholar]
- Nichol K. L., Lofgren R. P., Gapinski J. Influenza vaccination. Knowledge, attitudes, and behavior among high-risk outpatients. Arch Intern Med. 1992 Jan;152(1):106–110. doi: 10.1001/archinte.152.1.106. [DOI] [PubMed] [Google Scholar]
- Ohrt C. K., McKinney W. P. Achieving compliance with influenza immunization of medical house staff and students. A randomized controlled trial. JAMA. 1992 Mar 11;267(10):1377–1380. [PubMed] [Google Scholar]
- Pachucki C. T., Lentino J. R., Jackson G. G. Attitudes and behavior of health care personnel regarding the use and efficacy of influenza vaccine. J Infect Dis. 1985 Jun;151(6):1170–1171. doi: 10.1093/infdis/151.6.1170. [DOI] [PubMed] [Google Scholar]
- Potter J., Stott D. J., Roberts M. A., Elder A. G., O'Donnell B., Knight P. V., Carman W. F. Influenza vaccination of health care workers in long-term-care hospitals reduces the mortality of elderly patients. J Infect Dis. 1997 Jan;175(1):1–6. doi: 10.1093/infdis/175.1.1. [DOI] [PMC free article] [PubMed] [Google Scholar]
- Saxén H., Virtanen M. Randomized, placebo-controlled double blind study on the efficacy of influenza immunization on absenteeism of health care workers. Pediatr Infect Dis J. 1999 Sep;18(9):779–783. doi: 10.1097/00006454-199909000-00007. [DOI] [PubMed] [Google Scholar]
- Schwartz J. S., Lewis C. E., Clancy C., Kinosian M. S., Radany M. H., Koplan J. P. Internists' practices in health promotion and disease prevention. A survey. Ann Intern Med. 1991 Jan 1;114(1):46–53. doi: 10.7326/0003-4819-114-1-46. [DOI] [PubMed] [Google Scholar]
- Upshur R. E., Knight K., Goel V. Time-series analysis of the relation between influenza virus and hospital admissions of the elderly in Ontario, Canada, for pneumonia, chronic lung disease, and congestive heart failure. Am J Epidemiol. 1999 Jan 1;149(1):85–92. doi: 10.1093/oxfordjournals.aje.a009731. [DOI] [PubMed] [Google Scholar]
- Walsh J. M., McPhee S. J. A systems model of clinical preventive care: an analysis of factors influencing patient and physician. Health Educ Q. 1992 Summer;19(2):157–175. doi: 10.1177/109019819201900202. [DOI] [PubMed] [Google Scholar]
- Watanakunakorn C., Ellis G., Gemmel D. Attitude of healthcare personnel regarding influenza immunization. Infect Control Hosp Epidemiol. 1993 Jan;14(1):17–20. [PubMed] [Google Scholar]
- Wilde J. A., McMillan J. A., Serwint J., Butta J., O'Riordan M. A., Steinhoff M. C. Effectiveness of influenza vaccine in health care professionals: a randomized trial. JAMA. 1999 Mar 10;281(10):908–913. doi: 10.1001/jama.281.10.908. [DOI] [PubMed] [Google Scholar]
