Peri-Pandemic Acceptance of Influenza and COVID-19 Vaccination by Swiss Healthcare Workers in Primary Care 2020/21: A Cross-Sectional Study.

Objectives: To assess and compare influenza and COVID-19 vaccination uptake of Swiss healthcare workers (HCWs) in primary care 2020/21. Methods: Influenza and COVID-19 vaccination uptake and recommendation behaviours of HCWs in the primary care were assessed using an online semi-structured questionnaire. Associations between vaccination rates and age, language, gender, profession, vaccination history, vaccination training and recommendation behaviours were evaluated using descriptive and multivariable logistic regression analyses. Results: Vaccinated against COVID-19 in 2020/21 were 91.8% of the 1,237 participating HCWs, while 60.1% were vaccinated against influenza. Physicians and pharmacists presented the highest influenza vaccination rates (87.3%, 73.7%, respectively) compared to nurses (45.8%) and medical practice assistants (52.5%) while COVID-19 vaccination rates were high across all professions. Influenza and COVID-19 vaccination rates were significantly associated with age, profession, vaccination history, vaccination training and recommendation behaviours. Conclusion: Acceptance for influenza vaccination has increased during the pandemic but is lower than that for COVID-19 among the HCWs. Demographics, vaccination status and vaccination training impact the vaccination behaviour among HCWs and should be considered in future campaigns to increase vaccination uptake.

Influenza Vaccination Behaviour of Healthcare Workers in Switzerland: A Cross-Sectional Study.

Objectives: As no data are available regarding the influenza vaccination status of Swiss healthcare workers (HCW) in the ambulatory setting, this study aims to investigate their influenza vaccination behaviours. Methods: We conducted an online survey using a four-item, semi-structured questionnaire to assess HCWs influenza vaccination coverage and behaviour. Associations between influenza vaccination status, age and language as well as recommendation behaviour and reasons for vaccination were assessed using descriptive statistics and logistic regression analyses. Results: Of the 1057 completed questionnaires, 425 (40.2%) HCW were vaccinated and 632 (59.8%) not. 78.1% of the physicians and 47.3% pharmacists were vaccinated, compared to only 29.1% of the nurses, 24.3% pharmacy technicians and 13.0% medical practice assistants (MPA). There was a significant association between influenza vaccination status and HCW profession, age, language and how often an influenza vaccination recommendation was made. Conclusion: Demographic factors seem to influence HCWs' attitudes towards influenza vaccination, which in turn affects the prospect of them recommending the influenza vaccination. Diverse strategies might be necessary to encourage HCW to get vaccinated and hence, promote influenza vaccination.

Influence of cantonal health policy frameworks & activities on the influenza vaccination rate in patients with non-communicable diseases in Switzerland.

BACKGROUND AND OBJECTIVE: Seasonal influenza may cause serious illness, especially in high-risk populations such as older adults and individuals suffering from non-communicable diseases (NCD) and may be prevented by a vaccination. However, an assessment of the impact of the Swiss legal frameworks and number of health activities on influenza vaccination coverage of the population at the cantonal level is lacking. METHODS: Two participating healthcare insurers sent out 25,000 semi-structured questionnaires to their subscribers aged 60-85 in five Swiss cantons selected according to the number of health activities and legal framework regarding influenza vaccination and linguistic region. Influenza vaccination coverage of the participants was evaluated and stratified by disease status, age, canton, and linguistic region. Results were compared by cantonal activities, legal framework, and linguistic region. RESULTS: 7,617 valid questionnaires were evaluated from the cantons Aargau, Jura, St. Gallen, Schwyz, and Vaud. 47.9 % stated to have an NCD, with the most frequent being muscle/ skeletal disease (36.7%). Before 2018, 48.6% were vaccinated against influenza, and 35.9% in 2019, with the highest in canton Vaud. In all cantons and in both survey periods, NCD patients and those aged 73-85 had a higher vaccination coverage than participants without NCD, and aged 60-72. There was no difference in the odds of getting an influenza shot based on legal framework. Although a comparison of the number of activities between the German-speaking cantons did not reveal any significant differences, the odds of the participants living in a French-speaking canton getting an influenza vaccination was more likely than those living in a German-speaking canton. CONCLUSION: There was no association between the investigated cantonal frameworks and number of health activities and influenza vaccination coverage in NCD patients in the selected cantons. However, age, disease status and linguistic region appear to have an influence on vaccination uptake.

Evaluation of type 2 diabetes care management in nine primary care practices before and after implementation of the Criteria of Good Disease Management of Diabetes established by the Swiss Society of Endocrinology and Diabetology.

AIMS OF THE STUDY: Little is known about the quality of diabetes management of patients with type 2 diabetes mellitus (T2DM) in Swiss primary care. Based on the recommendations of the National Council Quality Assurance Programme, an interprofessional working group of the Swiss Society of Endocrinology and Diabetology (SSED) established population-based national criteria for good disease management of T2DM in primary health care (the diabetes score). The objective of this study was to assess whether the implementation of these criteria improve diabetes management in primary care. METHODS: The diabetes score comprises eight criteria including three biometric measurements, two lifestyle-specific items and screening of three diabetes-associated complications. Practices can evaluate adherence to the criteria based on a point system, with the recommended aim to achieve ≥70/100 points. Group practices and single practices were included in this study and started implementing the SSED criteria in January 2018. The resulting score was compared with data retrospectively obtained for 2017. The primary endpoint was the overall change in Diabetes Score between 2017 and 2018 at each practice, further stratified by practice type. The absolute effect on individual diabetes score criteria was assessed by pooling all patient-level data. RESULTS: Nine practices (six single and three group) participated in the study. In 2017 and 2018, the primary care practices treated 727 and 704 patients with T2DM, respectively, of whom 676 were treated both years. Around half of the patients were cared for in group practices and half in single practices. Between 2017 and 2018 the median (interquartile range) diabetes score improved from 40 (35, 65) to 55 (45, 70; p = 0.078). One practice (single) obtained a score ≥70 in 2017, three practices (all single) achieved this target in 2018. Pooling patient-level data, we observed a significant absolute improvement in the following criteria: number of regular diabetes check ups, body mass index, glycated haemoglobin, blood pressure, low density lipoprotein cholesterol and screenings for diabetes-associated complications (all p <0.05). However, the extent of the improvements were often insufficient to reach the prefixed targets of the diabetes score criteria on the practice level. CONCLUSION: Overall, the implementation of the SSED criteria in the current setting led to a modest, nonsignificant improvement of the diabetes score. Only three (all single practices) out of the nine practices reached the recommended 70-point target, indicating that further strategies are needed to improve diabetes care in primary care practice. Trial registration: ClinicalTrials.gov (ID NCT04216875).

[Results from a community based diabetic foot screening campaign]. / Résultats d'une campagne de dépistage du pied diabétique.

A community-based diabetic foot screening campaign was introduced during one week in the French-speaking part of Switzerland to emphasize the preventive impact of systematic foot inspections. Of 494 screened people, 46 % never had their feet checked - and as many as 63% if only standardized examinations according to the recommendations are considered. The risk of diabetic foot complications may appear as early as a few years after diagnosis, underlining the importance of a systematic annual check-up.

Une campagne de dépistage gratuit du pied diabétique a été organisée en Suisse romande pendant une semaine afin de sensibiliser les personnes diabétiques à l'importance de contrôles réguliers des pieds et d'améliorer l'accès aux soins pour tous. Sur les 494 personnes dépistées, 46 % n'avaient pas eu de contrôle préalable des pieds ­ et même 63 % si l'on ne considère que les examens réalisés selon les standards recommandés. Les risques de complication peuvent apparaître dès les premières années suivant le diagnostic, soulignant l'importance d'un contrôle annuel systématique.

Overview of the influenza vaccination activities and legal frameworks in 26 Swiss cantons during the influenza season 2019/20.

BACKGROUND: In Switzerland, the implementation of national health and prevention strategies is regulated at the cantonal level. To date, no in-depth inventory outlining the cantonal health activities and legal frameworks for influenza vaccination exists. OBJECTIVE: To assess the activities and legal frameworks for influenza vaccination during the 2019/20 season across all 26 Swiss cantons. METHOD: Survey using a structured closed-ended questionnaire. RESULTS: The activities' range across the cantons is broad from 11 activities in the canton Vaud to one in cantons Grisons and Jura. French/Italian-speaking cantons conduct 1.5 times more influenza vaccination activities on average than the German-speaking cantons. 23 of 26 cantons authorize influenza vaccination by pharmacists. All cantons allow nurses to vaccinate under the responsibility of a doctor. CONCLUSION: Influenza vaccination activities and vaccination-specific legal frameworks vary by canton and linguistic regions. Future vaccination strategies should consider concerted approaches to optimize their successful implementation.

Swiss interdisciplinary guidance on good practices for acute and complicated diabetic foot syndromes.

BACKGROUND: Diabetic foot syndromes (DFS) usually have negative outcomes for patients characterised by multiple comorbidities and frailty. In Switzerland, we need a nationwide "quality of care" programme consisting of evidence-based, practical guidance for primary care providers, together with the implementation of a multidisciplinary care system for DFS. METHODS: Elaboration of interprofessional and comprehensive Swiss practical guidance for the timely management of acute DFS. This guidance will not replace existing recommendations, but will be complementary to them. Before nationwide implementation, three Swiss pilot sites will test the guidance in collaboration with local interprofessional foot-care centres. RESULTS: Under the umbrella of QualiCCare, and endorsed by the professional societies involved, twenty experts from all relevant professions issued four protocols for various aspects of DFS between March 2018 and January 2020. In addition, they defined criteria for triage and treatment in primary care, as well as the timely referral of patients with DFS to interprofessional foot-care centres. We propose a framework for multidisciplinary, specialised foot-care networks, and interprofessional foot-care centres. The piloting of the proposed concepts is underway. All documents are available on the website www.qualiccare.ch. CONCLUSIONS: We provide evidence-based tools for Swiss primary care providers and specialists, and increase the accessibility for patients to specialised and timely care of DFS.

Immunisation coverage of adults: a vaccination counselling campaign in the pharmacies in Switzerland.

OBJECTIVE: To assess vaccination coverage for adults living in Switzerland. METHODS: Through a media campaign, the general population was invited during 1 month to bring their vaccination certificates to the pharmacies to have their immunisation status evaluated with the software viavac©, and to complete a questionnaire. RESULTS: A total of 496 pharmacies in Switzerland participated in the campaign, of which 284 (57%) submitted valid vaccination information. From a total of 3,634 participants in the campaign, there were 3,291 valid cases (participants born ≤ 1992) and 1,011 questionnaires completed. Vaccination coverage for the participants was 45.9% and 34.6% for five and six doses of diphtheria, 56.4% and 44.0% for tetanus and 66.3% and 48.0% for polio, respectively. Coverage estimates for one and two doses of measles vaccine were 76.5% and 49.4%, respectively, for the birth cohort 1967-1992 and 4.0% and 0.8%, respectively, for the cohort ≤ 1966. There was a significant difference in coverage for most vaccinations between the two aforementioned birth cohorts. A plot of the measles vaccine coverage over time shows that the increase in coverage correlated with policy changes in the Swiss Immunisation Schedule. CONCLUSIONS: Despite selection bias and low participation, this study indicates that vaccination coverage for the basic recommended immunisations in the adult population in Switzerland is suboptimal. More efforts using various means and methods are needed to increase immunisation coverage in adolescents before they leave school. An established method to determine vaccination coverage for the general population could provide invaluable insights into the effects of changes in vaccination policies and disease outbreaks.