Knowledge and Attitudes Regarding Category B ACIP Recommendations Among Primary Care Providers for Children
Knowledge and Attitudes Regarding Category B ACIP Recommendations Among Primary Care Providers for Children
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DOI：
10.1016/j.acap.2018.04.005
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发表时间：
2018-09-01
影响因子：
3.1
通讯作者：
Smith, Jean C.
中科院分区：
文献类型：
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作者：
Kempe, Allison;Allison, Mandy A.;Smith, Jean C.
目的：2015年，免疫实践咨询委员会(ACIP)对B群脑膜炎双球菌(MenB)疫苗的使用提出了B类建议，这意味着个人临床决策应指导建议。这是第一次使用与大量人口有关的B类建议，也是第一次针对青少年提出这类建议。作为一项关于MenB疫苗的调查的一部分，我们的目标是评估全国儿科医生(PED)和家庭医生(FP)：1)对A类和B类建议的含义和保险覆盖范围的了解，以及2)对A类和B类建议的态度。方法：我们从2016年10月至12月通过电子邮件和邮件调查了具有全国代表性的儿科医生和家庭医生(FP)样本。结果：回复率为72%(916人中有660人)。尽管80%的人正确地确定了A类建议的定义，但只有24%的人正确地确定了B类的定义。55%的人不知道私人保险会为推荐为B类的疫苗买单，51%的人不知道B类推荐的疫苗将纳入儿童疫苗计划。59%的人认为很难向患者解释B类建议；22%的人认为ACIP不应该提出B类建议；39%的人赞成B类建议，因为它们在决策中提供了回旋余地。结论：要使B类建议在指导实践中有用，初级保健临床医生需要更好地理解它们的含义，它们对保险支付的影响，以及如何与父母和患者讨论它们的指导。
OBJECTIVE: In 2015, the Advisory Committee on Immunization Practices (ACIP) made a category B recommendation for use of serogroup B meningococcal (MenB) vaccines, meaning individual clinical decision-making should guide recommendations. This was the first use of a category B recommendation pertaining to a large population and the first such recommendation for adolescents. As part of a survey regarding MenB vaccine, our objectives were to assess among pediatricians (Peds) and family physicians (FPs) nationally: 1) knowledge of the meaning of category A versus B recommendations and insurance coverage implications, and 2) attitudes about category A and B recommendations.METHODS: We surveyed a nationally representative sample of Peds and FPs via e-mail and mail from October to December 2016.RESULTS: The response rate was 72% (660 of 916). Although >80% correctly identified the definition of a category A recommendation, only 24% were correct about the definition for category B. Fifty-five percent did not know that private insurance would pay for vaccines recommended as category B, and 51% did not know that category B-recommended vaccines would be covered by the Vaccines for Children program. Fifty-nine percent found it difficult to explain category B recommendations to patients; 22% thought ACIP should not make category B recommendations; and 39% were in favor of category B recommendations because they provide leeway in decision-making.CONCLUSIONS: For category B recommendations to be useful in guiding practice, primary care clinicians will need to have a better understanding of their meaning, their implications for insurance payment, and guidance on how to discuss them with parents and patients.