Adult immunization in a network of family practice residency programs.
A substantial proportion of morbidity and mortality associated with vaccine-preventable diseases occurs among adults. Teaching residents about disease prevention is mandated in the curriculum guidelines for family practice programs. A cooperative study among the Kansas City family practice residency programs was begun to look at immunization behaviors in these teaching programs. A retrospective audit of medical records and a prospective survey of residents and faculty were performed. From the medical records of 400 patients seen for health maintenance examinations, the frequency of tetanus-diphtheria immunizations recorded was 4.75%. The pooled immunization rate recorded for pneumococcal vaccine was 25%, and for influenza vaccine, 24%. Although 93% of respondents knew patients need tetanus-diphtheria immunization every 10 years, on a written questionnaire giving clinical examples, they were less likely to elect to immunize older patients eligible for tetanus-diphtheria vaccine. The following immunization criteria were listed by respondents: for pneumococcal vaccine, age over 65 years (86%); for influenza vaccine, age over 65 years (85%), chronic diseases (69%), residence in a chronic care facility (7%), and being a health care worker (28%). Educational interventions stressing the appropriate criteria and involvement of the patient are planned at the separate programs.
Douglas
K C
KC
Family Practice Residency Program, Trinity Lutheran Hospital, Kansas City, MO.
Rush
D R
DR
O'Dell
M
M
Monroe
A
A
Ausmus
M
M
D000328:Adult; D000367:Age Factors; D000368:Aged; D004165:Diphtheria / Q000517:prevention & control; D004168:Diphtheria Toxoid; D005194:Family Practice / Q000193:education*; D006509:Hepatitis B / Q000517:prevention & control; D006801:Humans; D007114:Immunization / Q000706:statistics & numerical data*; D007115:Immunization Schedule; D007252:Influenza Vaccines; D007251:Influenza, Human / Q000517:prevention & control; D007396:Internship and Residency; D008485:Medical Audit; D008875:Middle Aged; D008923:Missouri; D011018:Pneumonia, Pneumococcal / Q000517:prevention & control; D011446:Prospective Studies; D012189:Retrospective Studies; D013742:Tetanus / Q000517:prevention & control; D013745:Tetanus Toxoid
D004168:Diphtheria Toxoid; D007252:Influenza Vaccines; D013745:Tetanus Toxoid