Perceived Needs and Barriers to Adult Pneumococcal Vaccination Among Primary Care Providers

Andrew W Urban, Heidi K Moore, Chris Larrison, Sheila Robertson, Marianna B Shershneva


Background: Dissemination of needs assessment findings advances the evidence base that informs educational research and practices. This needs assessment study explored perceptions and factors influencing clinicians’ behavior around pneumococcal vaccination.
Methods: This study utilized interviews with 32 primary care physicians (PCPs) and other clinicians, and an online survey answered by 97 PCPs, and 54 physician assistants (PAs) and nurse practitioners (NPs). Data collection focused on competencies, current practice, and barriers to improvement relative to adult pneumococcal vaccination. Qualitative analysis of the interview notes was followed by statistical analysis of survey responses, including PCPs versus PAs/NPs comparisons. The study was conducted in July 1, 2011 through January 31, 2012.
Results: Reported challenges included unfamiliarity with guidelines, providing vaccine during acute care visits, lack of reliable vaccination records, limitations of electronic medical records, and patient resistance. Analysis of competencies indicated multiple gaps, with the greatest gaps for implementing systems to remind about vaccinations, documenting vaccination plans, and using immunization registries. No significant differences were found between PCPs and PAs/NPs.
Conclusion: Continuing education and healthcare system changes are needed to improve pneumococcal disease prevention in primary care.

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