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Use of standing orders for adult influenza vaccination: A national survey of primary care physicians
Filetype[PDF - 82.83 KB]


Details:
  • Pubmed ID:
    21238862
  • Pubmed Central ID:
    PMC4070848
  • Funding:
    KL2 RR024154/RR/NCRR NIH HHS/United States
    KL2 TR000146/TR/NCATS NIH HHS/United States
    U50 CD300860/CD/ODCDC CDC HHS/United States
  • Document Type:
  • Collection(s):
  • Description:
    Background

    Influenza vaccination of adults remains below recommended levels. Standing orders programs (SOPs) that allow non-physician medical staff to assess eligibility and administer vaccines without an individualized physician’s order are a proven method to increase vaccination rates. However, recent data on their use is not available.

    Purpose

    Investigators surveyed primary care physicians nationwide in 2009 to assess factors related to awareness and use of SOPs.

    Methods

    Using the AMA Master list, a stratified random sample of U.S. family physicians (n=820) and general internists (n=820) was selected to receive a mailed questionnaire. The inclusion criterion was providing primary care to adults in an office-based practice. The primary outcome measure, analyzed in 2010, was consistent use of SOPs.

    Results

    The survey response rate was 67% (1015/1517). Forty-two percent of respondents who immunized adults in their practices reported consistent use of SOPs. Those physicians differed in several dimensions including, awareness of recommendations and regulations regarding SOPs for vaccines, size and type of practice, number and level of training of clinical staff, attributes of the staff. The two variables in logistic regression models associated with the highest likelihood of using SOPs were awareness of recommendations to use them (OR=3.0; 95% CI=2.2–4.1) and agreement with their effectiveness (OR= 2.7, 95% CI=1.9–3.8).

    Conclusion

    Fewer than half of physicians report using SOPs for influenza vaccination, a number that is not much higher than it was about a decade ago. Approaches to increase use of SOPs are needed.