title: Influenza vaccination in people with type 2 diabetes, coverage, predictors of uptake, and perceptions. Result of the MADIABETES cohort a 7years follow up study.
abstract: We aim to determine influenza vaccination uptake among people with diabetes included in the MADIABETES cohort study in order to identify predictors of uptake and to analyze reasons for adherence and non-adherence with vaccination.
  
  
  
  Using data from the MADIABETES Study we conducted a retrospective case record form based study without controls. We included outpatients with type 2 diabetes mellitus. Information was obtained from computerized clinical records and by telephone survey. The main dependent variables were influenza vaccination uptake in the year 2013 and the reason for receiving or refusing vaccination.
  
  
  
  Overall, 65.7% had received the influenza vaccine in 2013. The mean number of influenza vaccines received from 2007 to 2013 was 3.24 (SD1.15), although 19.23% had not received any influenza vaccine and 23.3% had been vaccinated against pneumococcus. The variables that increased the probability of being vaccinated were inclusion in the age-based recommendation (⩾60years), having a chronic respiratory disease, previous pneumococcal vaccination, higher number of visits to the general practitioner, higher number of influenza vaccines, and longer time since diabetes diagnosis. A higher mean glycated haemoglobin value in 2013 was associated with a reduced probability of vaccination. Most patients (90%) agreed to be vaccinated following their physician's advice because of their age or their chronic conditions. The most common reason for refusal among men was the belief that they were not at risk (41.6% vs. 29.79% in women); the most common reason for refusal among women was fear of adverse reactions (32.53% vs. 20.23% in men).
  
  
  
  The uptake of influenza vaccination among diabetic patients in the present study was below desirable levels. The main barrier to vaccination was lack of knowledge regarding the need for and risks and advantages of influenza vaccination. Healthcare professionals should educate and encourage influenza vaccination among people with diabetes.
authors.affiliation: Preventive Medicine and Public Health Teaching and Research Unit, Health Sciences Faculty, Rey Juan Carlos University, Alcorcón, Madrid, Spain. Electronic address: rodrigo.jimenez@urjc.es.
authors.forename: Rodrigo
authors.initials: R
authors.lastname: Jiménez-Garcia
authors.affiliation: Preventive Medicine and Public Health Teaching and Research Unit, Health Sciences Faculty, Rey Juan Carlos University, Alcorcón, Madrid, Spain.
authors.forename: Ana
authors.initials: A
authors.lastname: Lopez-de-Andres
authors.affiliation: Preventive Medicine and Public Health Teaching and Research Unit, Health Sciences Faculty, Rey Juan Carlos University, Alcorcón, Madrid, Spain.
authors.forename: Valentin
authors.initials: V
authors.lastname: Hernandez-Barrera
authors.affiliation: Aging and Fragility in the Elderly Group-IdiPAZ, Hospital Universitario La Paz, Madrid, Spain; MADIABETES Research Group, Madrid, Spain; Plataforma de Apoyo al Investigador Novel (PAIN Platform), Hospital Universitario La Paz-Institute for Health Research (IdiPAZ), Madrid, Spain.
authors.forename: Paloma
authors.initials: P
authors.lastname: Gómez-Campelo
authors.affiliation: MADIABETES Research Group, Madrid, Spain; Centro de Salud Las Calesas, Madrid, Spain.
authors.forename: Francisco J
authors.initials: FJ
authors.lastname: San Andrés-Rebollo
authors.affiliation: Aging and Fragility in the Elderly Group-IdiPAZ, Hospital Universitario La Paz, Madrid, Spain; MADIABETES Research Group, Madrid, Spain; Plataforma de Apoyo al Investigador Novel (PAIN Platform), Hospital Universitario La Paz-Institute for Health Research (IdiPAZ), Madrid, Spain; Dirección General de Salud Pública, Subdirección de Promoción, Prevención y Educación de la Salud, Consejería de Sanidad, Madrid, Spain; Red de Investigación en Servicios de Salud en Enfermedades Crónicas (REDISSEC), Madrid, Spain.
authors.forename: Carmen
authors.initials: C
authors.lastname: de Burgos-Lunar
authors.affiliation: Aging and Fragility in the Elderly Group-IdiPAZ, Hospital Universitario La Paz, Madrid, Spain; MADIABETES Research Group, Madrid, Spain; Dirección Técnica de Sistemas de Información, Gerencia Asistencial de Atención Primaria, Servicio Madrileño de Salud, Madrid, Spain; Universidad Alfonso X el Sabio, Villanueva de la Cañada, Madrid, Spain.
authors.forename: Juan
authors.initials: J
authors.lastname: Cárdenas-Valladolid
authors.affiliation: Aging and Fragility in the Elderly Group-IdiPAZ, Hospital Universitario La Paz, Madrid, Spain; MADIABETES Research Group, Madrid, Spain; Centro de Salud Monóvar, Madrid, Spain.
authors.forename: Juan Carlos
authors.initials: JC
authors.lastname: Abánades-Herranz
authors.affiliation: Aging and Fragility in the Elderly Group-IdiPAZ, Hospital Universitario La Paz, Madrid, Spain; MADIABETES Research Group, Madrid, Spain; Red de Investigación en Servicios de Salud en Enfermedades Crónicas (REDISSEC), Madrid, Spain; Subdirección General de Investigación Sanitaria, Consejería de Sanidad, Madrid, Spain.
authors.forename: Miguel Angel
authors.initials: MA
authors.lastname: Salinero-Fort
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D048909:Diabetes Complications / Q000517:prevention & control*; D003924:Diabetes Mellitus, Type 2 / Q000150:complications*; D005260:Female; D005500:Follow-Up Studies; D007722:Health Knowledge, Attitudes, Practice; D006801:Humans; D007252:Influenza Vaccines / Q000008:administration & dosage*; D007251:Influenza, Human / Q000517:prevention & control*; D008297:Male; D008875:Middle Aged; D010342:Patient Acceptance of Health Care; D012189:Retrospective Studies; D014611:Vaccination / Q000523:psychology* / Q000706:statistics & numerical data*
chemical_list: D007252:Influenza Vaccines
keywords: Diabetes; Influenza; Perceptions; Predictors; Uptake; Vaccine