Primary Care Physicians' Perspectives About HPV Vaccine.
Primary Care Physicians' Perspectives About HPV Vaccine.
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DOI：
10.1542/peds.2015-2488
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发表时间：
2016-02
期刊：
影响因子：
8
通讯作者：
Kempe A
中科院分区：
文献类型：
--
作者：
Allison MA;Hurley LP;Markowitz L;Crane LA;Brtnikova M;Beaty BL;Snow M;Cory J;Stokley S;Roark J;Kempe A
由于医生的做法可以修改，以减少错过的人乳头瘤病毒（HPV）疫苗接种的机会，我们的目标是：(1)描述自我报告的做法，推荐HPV疫苗；(2)估计父母推迟接种HPV疫苗的频率；(3)找出与不讨论相关的特征。2013年10月至2014年1月对儿科医生和家庭医生（FP）进行了全国调查。使用多变量分析，检查与未讨论HPV疫苗接种相关的特征。儿科医生的有效率为82%（442人中有364人），计划生育医生的有效率为56%（387人中有218人）。对于11-12岁的女孩，60%的儿科医生和59%的计划生育医生强烈建议接种HPV疫苗；对于男孩，52%和41%的人强烈推荐。超过一半的报告≥25%的父母推迟了HPV疫苗接种。在11-12岁的健康访问中，84%的儿科医生和75%的计划生育医生经常/总是讨论HPV疫苗接种。与经常/总是讨论的医生相比，偶尔/很少讨论的医生（18%）更有可能是FP（调整优势比[aOR]: 2.0[95%可信区间（CI）： 1.1-3.5），男性（aOR: 1.8 [95% CI: 1.1-3.1]），不同意父母在与其他疫苗讨论后会接受HPV疫苗（aOR: 2.3 [95% CI: 1.3-4.2]），报告为25%至49% （aOR: 2.8 [95% CI: 1.1-6.8]）或≥50% （aOR: 7.8 [95% CI: 95% CI: 1.1-6.8]）。3.4 - 17.6])，并表达了对免疫力下降的担忧（aOR: 3.4 [95% CI: 1.8-6.4]）。解决医生对父母接受HPV疫苗的看法，与其他推荐的疫苗讨论HPV疫苗接种的可能优势，以及对免疫力下降的担忧可能导致疫苗接种率增加。
Because physicians’ practices could be modified to reduce missed opportunities for human papillomavirus (HPV) vaccination, our goal was to: (1) describe self-reported practices regarding recommending the HPV vaccine; (2) estimate the frequency of parental deferral of HPV vaccination; and (3)identify characteristics associated with not discussing it. A national survey among pediatricians and family physicians (FP) was conducted between October 2013 and January 2014. Using multivariable analysis, characteristics associated with not discussing HPV vaccination were examined. Response rates were 82% for pediatricians (364 of 442) and 56% for FP (218 of 387). For 11–12 year-old girls, 60% of pediatricians and 59% of FP strongly recommend HPV vaccine; for boys,52% and 41% ostrongly recommen. More than one-half reported ≥25% of parents deferred HPV vaccination. At the 11–12 year well visit, 84% of pediatricians and 75% of FP frequently/always discuss HPV vaccination. Compared with physicians who frequently/always discuss, those who occasionally/rarely discuss(18%) were more likely to be FP (adjusted odds ratio [aOR]: 2.0 [95% confidence interval (CI): 1.1–3.5), be male (aOR: 1.8 [95% CI: 1.1–3.1]), disagree that parents will accept HPV vaccine if discussed with other vaccines (aOR: 2.3 [95% CI: 1.3–4.2]), report that 25% to 49% (aOR: 2.8 [95% CI: 1.1–6.8]) or ≥50% (aOR: 7.8 [95% CI: 3.4–17.6]) of parents defer, and express concern about waning immunity (aOR: 3.4 [95% CI: 1.8–6.4]). Addressing physicians’ perceptions about parental acceptance of HPV vaccine, the possible advantages of discussing HPV vaccination with other recommended vaccines, and concerns about waning immunity could lead to increased vaccination rates.