Swiss primary care physicians reporting of utility and use of recommended vaccinations for adults.

QUESTION: To determine how recommended vaccinations in adults are perceived and used by primary care physicians in Switzerland.

METHODS

A cross-sectional mail survey of primary care physicians randomly selected from the register of the Swiss medical association was conducted, including specific items measuring perceived utility and reported use for fourteen recommended vaccinations for adults. The answers were standardized to have a minimum of 0 and a maximum of 100. Other items assessed socio-demographic and work characteristics, opinion regarding the use of vaccinations, sources of recommendations used for vaccinations, and patient and organisational barriers. Frequency tables and crosstabulations were used to describe differences in perceived utility and reported use across these characteristics.

RESULTS

After three reminders, 1166 physicians participated in the survey (response rate 64%). Perceived utility was the highest for rubella immunisation in young women (93.6; 95% CI: 92.8 to 94.3) and hepatitis B immunisation in high-risk adults (91.9; 95% CI: 91.0 to 92.7); it was the lowest for immunisations against measles (56.7; 95% CI: 55.3 to 58.2) and pneumococcal diseases (55.2; 95% CI: 53.8 to 56.7). The highest levels of use were reported for diphtheria-tetanus booster after a wound (91.7; 95% CI: 90.7 to 92.7) and poliomyelitis immunisation of travelers (89.5; 95% CI: 88.4 to 90.6); the lowest for immunisations against measles (40.3; 95% CI: 38.5 to 42.1) and pneumococcal diseases (33.3; 95% CI: 31.8 to 34.8). Lower reported use was associated with reports of physicians not having the time to verify vaccination status and convince a patient to be immunised, and other logistic issues related to physician's practice, but not with reports of patient's refusal of immunisation.

CONCLUSION

There are several avenues to strengthen promotion programs aiming at improving immunisation use by Swiss primary care physicians in adults, among which a high better recognition of time spent for health promotion activities should have priority.