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Second European Influenza Conference Malta, September 11-14, 2005 Recommendations and guidelines on influenza vaccinatio

EUROPREV. European Network for Prevention and Health Promotion in Family Medicine and General Practicewww.europrev.org. EUROPREV (www.europrev.org) . European network of national colleges of general practice/family medicine established in 1996 and affiliated to WONCA-Europe (at the present t

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Second European Influenza Conference Malta, September 11-14, 2005 Recommendations and guidelines on influenza vaccinatio

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    1. Second European Influenza Conference Malta, September 11-14, 2005 Recommendations and guidelines on influenza vaccination and treatment Dr. Carlos Brotons EUROPREV chairman The role of European general practitioners in influenza vaccination

    2. EUROPREV European Network for Prevention and Health Promotion in Family Medicine and General Practice www.europrev.org

    3. EUROPREV (www.europrev.org) European network of national colleges of general practice/family medicine established in 1996 and affiliated to WONCA-Europe (at the present time 22 countries in Europe are represented) general aim: promote evidence-based prevention in general practice.

    4. The role of European general practitioners in influenza vaccination EUROPREV Survey Objective To explore the policies of national colleges of GPs regarding recommendations and guidelines on influenza vaccination

    5. The role of European general practitioners in influenza vaccination EUROPREV Survey Methods Email survey (june-august 2005) 16 questions about : Guidelines-recommendations Specific questions about influenza vaccination Specific questions about the role of GPs and EUROPREV network

    6. The role of European general practitioners in influenza vaccination EUROPREV Survey National colleges of GPs from 14 European countries participated in the survey: Austria, Belgium, Croatia, Cyprus, Greece, Malta, Poland, Portugal, Slovenia, Spain, Sweden, Switzerland, The Netherlands, Turkey

    7. The role of European general practitioners in influenza vaccination Does your National College of GPs have its own guidelines/recommendations on influenza vaccination?

    8. The role of European general practitioners in influenza vaccination Has the Department of Health of your country published guidelines/recommendations on influenza vaccination and treatment?

    9. The role of European general practitioners in influenza vaccination Webpages The Netherlands: http://nhg.artsennet.nl; www.gr.nl Spain: www.papps/recomendaciones/esperto1.pdf; www.gencat.net/salut/depsan/units/sanitat/pdf/guiavagrip.pdf Belgium: www.wvvh.be/files/influenza_kb_engels-htm Austria: www.impf.at Croatia: www.hzjz.hr Portugal: www.dgsaude.pt/upload/menmbro.id/ficheiros/i006516.pdf Switzerland: www.grippe.admin.ch Greece: www.mohaw.gr Sweden: www.sos.se/sosfs/1997_21/1997_21.htm

    10. The role of European general practitioners in influenza vaccination Is the following recommendation for influenza vaccination the one that is being used in your country?: ‘Annual influenza vaccination for people older than 6 months with chronic respiratory disease, chronic heart disease, chronic renal failure, diabetes mellitus, inmunosuppression due to disease or treatment, and for everyone older than 65 and people who live in care homes. Also health care workers in contact with high-risk persons; household contacts of high-risk persons.’ (Ref: WHO. Influenza vaccines: Recommendations for the use of inactivated influenza vaccines and other preventive measures. Weekly epidemiological record, 2000, 75, 281–288. http://www.who.int/docstore/wer/pdf/2000/wer7535.pdf - accessed 13th June 2005)

    11. The role of European general practitioners in influenza vaccination Reasons for discrepancies with the WHO recommendation: over 60 years only people > 65 years children > 2 years not in patients with chronic renal failure, immunosuppression, not in health care workers

    12. The role of European general practitioners in influenza vaccination What are the usual distribution channels of influenza vaccination in your country? GPs 11 (78%) Primary Care Services 8 (57%) Public Health Authorities 6 (43%) Occupational Health Authorities 3 (21%) Others: local pharmacists, companies who promote vaccination for their employees,..

    13. The role of European general practitioners in influenza vaccination What is the reported influenza vaccination uptake among the elderly (age 65 and older) in your country? Ranging from 18% to 82% Not known: 8 (57%)

    14. The role of European general practitioners in influenza vaccination Do you know the national uptake target in your country for people aged 65 and older? Ranging from 50 to 85% Not known: 9 (64%)

    15. The role of European general practitioners in influenza vaccination Are there any strategies in your country intended to increase uptake rates? YES 12 (86%) Financial incentives for GPs 3 (21%) Personal invitations to patients 5 (36%) Personal reminders to GPs 4 (28%) Vaccination free of charge 6 (43%) Mass media campaigns 11 (79%) Others: price reduction, coordinated national programme, leaflets,.. NO 2 (14%)

    16. The role of European general practitioners in influenza vaccination In your country, are vaccination rates of different risks groups monitored? YES 10 (71%) Surveys among general population 6 (60%) Surveys among health professionals 2 (20%) Compulsory reports made to health authorities by providers of vaccinations 4 (40%) Data from sentinel networks 5 (50%) NO 4 (29%)

    17. The role of European general practitioners in influenza vaccination Is influenza vaccination in your country free of charge for population at risk? NO: fixed price ranging from 5,61 euros to 20 euros

    18. The role of European general practitioners in influenza vaccination Is influenza vaccination in your country free of charge for healthy population? NO: fixed price from 5,10 euros to 35 euros

    19. The role of European general practitioners in influenza vaccination Is influenza vaccination being used in your country as one of the clinical quality indicators in primary care (i.e. % of patients older than 65 immunized against influenza …)

    20. The role of European general practitioners in influenza vaccination Are you aware of any of the following changes (recently implemented or to be implemented in the future) in relation with influenza vaccination policies in your country? Lowering the age limit for vaccination from 65 to 60 (or even to 50) 6 (43%) Immunisation of all children age 6-23 months 4 (29%) Immunisation of people in close contact (parents, ..) with children age 0-23 months 0 (0%) Others: vaccinating pregnant women 1 (7%)

    21. The role of European general practitioners in influenza vaccination What do you think could be the role of GPs (or your national college) in your country to protect populations against epidemic and pandemic influenza? GPs Inform patients and promote vaccination Know % of patients at risk Health education in local communities (jointly with nurses) Participate in sentinel networks National Colleges of GPs Developing guidelines Collaboration with governments Organising training Implementing QA criteria/influenza vaccination as clinical quality indicator

    22. The role of European general practitioners in influenza vaccination What do you think could be the role of the EUROPREV network to protect European populations against epidemic and pandemic influenza? Acting as a means for carrying out research, communicating and collaboration within the European General Practice. Keeping European GPs (through their colleges) up-to-date with information and guidelines for their use and for the use of the general public. Disseminate best practices based upon the existing guidelines and protocols in countries with a high vaccination rate. Support national guidelines development Monitor regulations, praxis, vaccinations rates,.. among different European countries. Lobbying for free vaccination for population at risk

    23. The role of European general practitioners in influenza vaccination Are you and your immediate family immunized against influenza? Yourself YES 9 (64%) Parents YES 9 (69%) Partner YES 9 (64%) Children YES 4 (31%)

    24. The role of European general practitioners in influenza vaccination If an influenza epidemic/pandemic strikes your country: Do you feel that as a GP you are trained to handle the situation? YES 6 (43%) Would you undergo training in handling such an emergency situation? YES 12 (86%) Would you volunteer your services to the government free-of-charge? YES 6 (43%) Would you require financial support to offer your services to the government? YES 8 (57%)

    25. The role of European general practitioners in influenza vaccination Conclusions In 5 countries neither the National College nor the Department of Health have published guidelines/recommendations There are discrepancies with the recommendation on influenza vaccination. In 43% of the countries influenza vaccination IS NOT free of charge for population at risk It would be important to incorporate influenza vaccination as one of the clinical quality indicators in primary care (only 21% of the countries are using it as indicator)

    26. The role of European general practitioners in influenza vaccination Conclusions The most important role of : GPs : to inform patients and promote vaccination National Colleges of GPs: to develop and implement guidelines and clinical quality indicators EUROPREV : to collaborate with national colleges to develop and disseminate guidelines, to promote communication and research at European level to lobby jointly with other organisations/institutions for free vaccination for population at risk

    27. The role of European general practitioners in influenza vaccination Acknowledgements Austria: Ingrid Pichler, Anita Rieder Belgium: Frans Govaerts Croatia: Jasna Vucak, Ivan Stipanov Cyprus: Valia Markou Greece: Eleftherios Thireos_ Malta: Mario R Sammut, Tanya Melillo-Fenech Poland: Maciek Godycki-Cwirko Portugal: Carlos Martins Slovenia: Mateja Bulc Spain: Carlos Brotons, Ramon Ciurana, Pilar Kloppe, Rosa Piñeiro, MJ Álvarez Pasquín, Javier Gómez Sweden: Cecilia Bjorkelund Switzerland: Maxime Mancini, Ueli Grueninger The Netherlands: Ton Drenthen, Louwrens Boomsma, Fieke Molster Turkey: Suleyman Gorpelioglu

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