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1.
BMC Prim Care ; 24(1): 148, 2023 07 15.
Article in English | MEDLINE | ID: mdl-37452283

ABSTRACT

BACKGROUND: The current uptake of many vaccinations recommended for persons aged 60 and older is unsatisfactory in Germany. Lack of confidence in the safety and efficacy of vaccinations, lack of knowledge and insecurities about possible side effects, and numerous pragmatic barriers are just some of the reasons to be mentioned. General practitioners (GPs) play a central role in the vaccination process. Therefore, effective interventions in this context are needed to address the various barriers and improve the vaccination uptake rates. METHODS: A complex intervention will be implemented and evaluated in 1057 GPs' practices in two German federal states. The components include trainings for GPs and medical assistants on communication psychology, medical aspects, and organisational vaccination processes. The primary outcome influenza vaccination rate and the secondary outcomes vaccination uptake rate of other vaccinations as well as vaccine literacy of patients will be examined. The intervention will be evaluated in a mixed methods study with a controlled design. Survey data will be analysed descriptively and by using mean comparisons as well as multivariable multilevel analyses. The qualitative data will be analysed with qualitative content analysis. The secondary data will be analysed by using descriptive statistics, a pre-post comparison by performing mean comparisons, cluster analysis, and subgroup analyses. DISCUSSION: In this study, a complex intervention to improve vaccination rates in GP practices for the vaccinations recommended for people aged 60 years and older will be implemented and evaluated. Additionally, improvements in patients' vaccine-related health literacy and knowledge, and patients' intention to get vaccinated are expected. The mixed methods design can deliver results that can be used to improve preventive health care for elderly people and to gain more knowledge on vaccination uptake and the intervention's effectiveness. TRIAL REGISTRATION: Trial registration number: DRKS00027252 (retrospectively registered).


Subject(s)
General Practitioners , Influenza Vaccines , Influenza, Human , Aged , Humans , Middle Aged , Allied Health Personnel , General Practitioners/psychology , Influenza Vaccines/therapeutic use , Influenza, Human/prevention & control , Influenza, Human/drug therapy , Vaccination/psychology
2.
JMIR Res Protoc ; 9(9): e18648, 2020 Sep 30.
Article in English | MEDLINE | ID: mdl-32996888

ABSTRACT

BACKGROUND: The emergence and increased spread of microbial resistance is a major challenge to all health care systems worldwide. In primary care, acute respiratory tract infection (ARTI) is the health condition most strongly related to antibiotic overuse. OBJECTIVE: The RESIST program aims at optimizing antibiotic prescribing for ARTI in German primary care. By completing a problem-orientated online training course, physicians are motivated and empowered to utilize patient-centered doctor-patient communication strategies, including shared decision making, in the treatment of patients with ARTI. METHODS: RESIST will be evaluated in the form of a nonrandomized controlled trial. Approximately 3000 physicians of 8 (out of 16) German federal states can participate in the program. Patient and physician data are retrieved from routine health care data. Physicians not participating in the program serve as controls, either among the 8 participating regional Associations of Statutory Health Insurance Physicians (control group 1) or among the remaining associations not participating in RESIST (control group 2). Antibiotic prescription rates before the intervention (T0: 2016, 1st and 2nd quarters of 2017) and after the intervention (T1: 3rd quarter of 2017 until 1st quarter of 2019) will be compared. The primary outcome measure is the overall antibiotic prescription rate for all patients insured with German statutory health insurance before and after provision of the online course. The secondary outcome is the antibiotic prescription rate for coded ARTI before and after the intervention. RESULTS: RESIST is publicly funded by the Innovations funds of the Federal Joint Committee in Germany and was approved in December 2016. Recruitment of physicians is now completed, and a total of 2460 physicians participated in the intervention. Data analysis started in February 2020. CONCLUSIONS: With approximately 3000 physicians participating in the program, RESIST is among the largest real-world interventions aiming at reducing inadequate antibiotic prescribing for ARTI in primary care. Long-term follow up of up to 21 months will allow for investigating the sustainability of the intervention. TRIAL REGISTRATION: ISRCTN Registry ISRCTN13934505; http://www.isrctn.com/ISRCTN13934505. INTERNATIONAL REGISTERED REPORT IDENTIFIER (IRRID): RR1-10.2196/18648.

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