Reasons for failure to receive pneumococcal and influenza vaccinations among immunosuppressed patients with systemic lupus erythematosus.
Reasons for failure to receive pneumococcal and influenza vaccinations among immunosuppressed patients with systemic lupus erythematosus.
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DOI：
10.1016/j.semarthrit.2015.01.002
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发表时间：
2015-06
影响因子：
5
通讯作者：
Yazdany J
中科院分区：
文献类型：
--
作者：
Lawson EF;Trupin L;Yelin EH;Yazdany J
为了更好地理解为什么免疫抑制的系统性红斑狼疮（SLE）患者不能接种流感和肺炎球菌疫苗。这些横断面数据来源于2009年狼疮结局研究（LOS），这是一项对确诊SLE患者进行的年度纵向电话调查。如果受访者在过去一年中服用了免疫抑制药物，则将其纳入分析。我们评估了过去一年中是否接种过肺炎球菌疫苗和流感疫苗，然后得出未接种疫苗的原因。我们使用二元统计和多元逻辑回归来评估未获得流感或肺炎球菌疫苗的报告原因的频率和预测因素。在接受免疫抑制剂的508名受访者中，485人报告了他们是否接受过疫苗接种。在175名未接种流感疫苗的受访者中，最常见的原因是缺乏医生建议（55%），其次是有效性或安全性问题（21%）和缺乏时间（19%）。未接种肺炎球菌疫苗的原因（N=159）相似：缺乏推荐（87%），缺乏时间（7%）和有效性或安全性问题（4%）。年轻、受教育程度低、病程较短的非白人患者，以及仅使用类固醇进行免疫抑制的患者，不接受指定疫苗建议的风险最大。SLE患者没有接种肺炎球菌和流感疫苗的最常见原因是医生没有推荐。数据表明，提高SLE的疫苗接种率将需要在提供者层面提高过程质量，以及解决患者的问题和障碍。
To better understand why immunosuppressed individuals with systemic lupus erythematosus (SLE) fail to receive influenza and pneumococcal vaccines. These cross-sectional data derive from the 2009 cycle of the Lupus Outcomes Study (LOS), an annual longitudinal telephone survey of individuals with confirmed SLE. Respondents were included in the analysis if they had taken immunosuppressive medications in the past year. We assessed any prior receipt of pneumococcal vaccine and receipt of influenza vaccine in the past year, then elicited reasons for not receiving vaccination. We used bivariate statistics and multivariate logistic regression to assess frequency and predictors of reported reasons for not obtaining influenza or pneumococcal vaccines. Among 508 respondents who received immunosuppressants, 485 reported whether they had received vaccines. Among the 175 respondents who did not receive an influenza vaccine, the most common reason was lack of doctor recommendation (55%), followed by efficacy or safety concerns (21%), and lack of time (19%). Reasons for not receiving pneumococcal vaccine (N=159) were similar: lack of recommendation (87%), lack of time (7%), and efficacy or safety concerns (4%). Younger, less-educated, non-white patients with shorter disease duration, as well as those immunosuppressed with steroids alone, were at greatest risk for not receiving indicated vaccine recommendations. The most common reason why individuals with SLE did not receive pneumococcal and influenza vaccines was that physicians failed to recommend them. Data suggest that increasing vaccination rates in SLE will require improved process quality at the provider level, as well as addressing patient concerns and barriers.
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影响因子：
5.5
作者：
Taitel, Michael;Cohen, Ed;Pegus, Cheryl
通讯作者：
Pegus, Cheryl
DOI：
10.1002/art.22481
发表时间：
2007-02-15
期刊：
ARTHRITIS & RHEUMATISM-ARTHRITIS CARE & RESEARCH
影响因子：
--
作者：
Yelin, Edward;Trupin, Laura;Panopalis, Peter
通讯作者：
Panopalis, Peter
影响因子：
4.9
作者：
Yazdany, Jinoos;Tonner, Chris;Yelin, Edward H.
通讯作者：
Yelin, Edward H.
影响因子：
5.5
作者：
Mac Donald, R;Baken, L;Nichol, KL
通讯作者：
Nichol, KL
DOI：
10.1002/art.23346
发表时间：
2008-02-15
期刊：
ARTHRITIS & RHEUMATISM-ARTHRITIS CARE & RESEARCH
影响因子：
--
作者：
Ward, Michael M.
通讯作者：
Ward, Michael M.