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Pneumococcal vaccination in general internal medicine practice: current practice and future possibilities
Allison Kempe1, Laura Hurley, Shannon Stokley
1Department of Pediatrics, University of Colorado Denver, Denver, CO, USA. Kempe.allison@tchden.org
Journal of General Internal Medicine
|October 3, 2008
Summary
Most internists administer the pneumococcal vaccine (PPV), but barriers like competing demands and poor patient identification hinder its use. A universal adult vaccination policy could improve PPV delivery.
Area of Science:
- Internal Medicine
- Public Health
- Vaccinology
Background:
- Pneumococcal vaccine (PPV) is recommended for adults aged 65 and older and those with chronic illnesses.
- Potential benefits exist for universal PPV vaccination in adults aged 50-64 years.
Purpose of the Study:
- Assess general internists' PPV recommendations and administration practices.
- Identify barriers to PPV vaccination.
- Evaluate internists' willingness to expand PPV to all adults aged 50 and older.
Main Methods:
- A national survey of general internists, representative of the American College of Physicians, was conducted.
- The survey assessed current vaccination practices, perceived barriers, and attitudes towards expanded vaccination guidelines.
Main Results:
- A high percentage of internists (99%) reported administering PPV.
- Fewer than 20% used computerized systems for patient identification, and only 6% recalled patients for vaccination.
- Key barriers included competing acute care demands (39%), difficulty with vaccination history (30%), low priority (20%), and inadequate reimbursement (19%).
Conclusions:
- While most internists administer PPV, delivery is hampered by competing priorities, inadequate identification systems, and reimbursement challenges.
- A universal vaccination policy for adults aged 50 and older could potentially reduce these barriers.
- A majority of physicians indicated they would adopt expanded PPV recommendations if officially made.
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