The effect of physicians’ awareness on influenza and pneumococcal vaccination rates and correlates of vaccination in patients with diabetes in Turkey

Abstract

We aimed to examine the effect of increased physician awareness on the rate and determinants of influenza and pneumococcal vaccinations in diabetic patients. Diabetic patients (n = 5682, mean [SD] age: 57.3 [11.6] years, 57% female) were enrolled by 44 physicians between Sept 2010 and Jan 2011. The physicians were initially questioned regarding vaccination practices, and then, they attended a training program. During the last five years, the physicians recommended influenza and pneumococcal vaccinations to 87.9% and 83.4% of the patients, respectively; however; only 27% of the patients received the influenza and 9.8% received the pneumococcal vaccines. One year after the training, the vaccination rates increased to 63.3% and 40.7%, respectively. The logistic regression models revealed that variables which increased the likelihood of having been vaccinated against influenza were: longer duration of diabetes, presence of hyperlipidemia and more use of concomitant medications whereas more use of anti-hyperglycemic medications was associated with increased odds of vaccination. On the other hand, older age, longer duration of diabetes and presence of a cardiovascular disease were variables which decreased the likelihood of having been vaccinated against pneumococcal disease during the past five years. However, during the study period, variables which decreased the odds of having been vaccinated included: older age and anti-hyperglycemic medications for influenza, and presence of hyperlipidemia and a family history of hypertension for pneumococcal disease. While variables which increased the likelihood of vaccination in the same period were: increased number of co-morbidities for influenza, and family history of diabetes for pneumococcal disease. We conclude that increased awareness of physicians may help improve vaccination rates against influenza and pneumococcal disease. However, diabetic patients with more severe health conditions are less likely to having been vaccinated. More structural/systematic vaccination programs are needed to increase the vaccination rates in patients with diabetes.

Keywords: :

• influenza vaccine
• pneumococcal vaccine
• diabetes mellitus
• adult
• immunization programs

Submitted

04/21/13

Revised

07/02/13

Accepted

07/22/13

Disclosure of Potential Conflicts of Interest

The authors declared no conflict of interest, except for Dr Serdar Altinel having been an employee at Sanofi-Pasteur, Turkey, at the time of conduction of the study.

Acknowledgments

This study was conducted by The Diabetes Study Group of The Society of Endocrinology and Metabolism of Turkey with an unrestricted/unconditioned educational grant provided by Sanofi-Pasteur, Turkey. The authors would like to express their gratitude to Ms Esra Koruyucu, Arzu Calisgan MSc, and Oguz Akbas MD from Monitor CRO for the data entry, statistical analysis and first drafting of the paper, and also thank to Professor Sibel Kalaca, MD as she kindly reviewed the statistical analysis.

Supplemental Materials

Supplemental materials may be found here: http://www.landesbioscience.com/journals/vaccines/article/25826/