title: Delivering influenza vaccine to high-risk adults: subspecialty physician practices.
abstract: Influenza is responsible for significant morbidity and mortality in the United States. Despite long-standing national recommendations, only 47% of adults with a high-risk condition received the influenza vaccine in 2009-2010. Subspecialty practices provide a significant portion of ambulatory care visits for high-risk adults and understanding their role in the immunization infrastructure may increase immunization rates, decrease public health burden, and reduce influenza-associated disease. A cross-sectional survey of cardiology, pulmonology, and obstetrics/gynecology practices was conducted to assess influenza vaccination practices, plans, patient acceptance, frustrations, and reasons for not vaccinating. It was found that 51% of respondents planned to vaccinate patients. Plans differed significantly by practice type. Practices that do not vaccinate generally recommend vaccination and refer patients to public health clinics, primary care, and pharmacies.   Administrative and patient-related barriers affected most practices, but practices that vaccinate were able to overcome these barriers. Improvements in vaccination may be addressed by adapting practice support services for subspecialty practices.
authors.affiliation: University of the Sciences in Philadelphia, Philadelphia, PA 19104, USA. a.jessop@usciences.edu
authors.forename: Amy B
authors.initials: AB
authors.lastname: Jessop
authors.forename: Harry
authors.initials: H
authors.lastname: Dumas
authors.forename: Charlotte A
authors.initials: CA
authors.lastname: Moser
mesh_terms: D000328:Adult; D002309:Cardiology / Q000706:statistics & numerical data; D003430:Cross-Sectional Studies; D006176:Gynecology / Q000706:statistics & numerical data; D006801:Humans; D007252:Influenza Vaccines / Q000627:therapeutic use*; D007251:Influenza, Human / Q000517:prevention & control; D008511:Medicine / Q000379:methods / Q000706:statistics & numerical data*; D009774:Obstetrics / Q000706:statistics & numerical data; D010342:Patient Acceptance of Health Care / Q000706:statistics & numerical data; D010818:Practice Patterns, Physicians' / Q000706:statistics & numerical data*; D015272:Pulmonary Medicine / Q000706:statistics & numerical data; D012307:Risk Factors
chemical_list: D007252:Influenza Vaccines