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Prevention into practice: Working to bridge gaps in adult vaccination


Morgan Liotta


7/06/2019 2:57:42 PM

Associate Professor John Litt discussed the benefits of preventive healthcare during a recent presentation at the APNA conference.

Green Book
Associate Professor Litt cited the RACGP’s Green Book as a good starting point to implementing preventive healthcare measures.

Associate Professor John Litt is a member of the RACGP’s Putting prevention into practice: Guidelines for the implementation of prevention in the general practice setting (Green Book) Editorial Committee.
 
In his presentation at the recent Australian Primary Healthcare Nurses Association (APNA) 2019 national conference, he discussed principles from the Green Book in order to improve older adult vaccination rates in practice.
 
One of the drivers behind an increased focus on adult vaccination is a significantly lower coverage compared to children, so elder adults ‘often don’t pay the same degree of attention’, according to Associate Professor Litt.
 
He also reminded attendees that the last national survey on vaccination for older people was in 2009, so it is ‘long overdue’ for another.
 
Given that flu season has well and truly arrived, vaccination for influenza, herpes zoster and pneumococcal infection – particularly community-acquired pneumonia – were of key focus in Associate Professor Litt’s presentation.
 
‘Flu happens every year... In a typical season, we will have something like 5% of the population who will develop influenza over the flu season,’ he said.
 
‘And the impact and burden of that disease falls particularly on older people – 90% of hospital admissions are people over the age of 65 – so we really need to ensure that group of people get the flu vaccine every year.’
 
Associate Professor Litt cited the Green Book as a good starting point to implementing preventive healthcare measures, acknowledging that preventive care integrates other fundamental elements of the patient–practitioner relationship: dedication and support.
 
‘Implementation is the sort of poor cousin in that when we have healthcare interventions, we spend a lot of time getting there in terms of the science and running the trials,’ he said.
 
‘We pay very little attention and time to the things that actually make a difference, to make sure that people get those very effective interventions and vaccines so we get health outcomes. So that’s where the Green Book comes in to place.
 
‘If we take our time as an effective intervention, and we spend twice as long with patients, we’re going to get twice the health benefit. So trying to have some sort of effect in an area, it’s really important to look at the reach, and make sure that various people are covered and offered the intervention.’
 


Associate Professor Litt broke down some of the reasons people may be vaccine-hesitant, and discussed the importance of the healthcare provider’s role is in providing advice on the subject.
 
‘It [vaccine hesitancy] commonly centres around concern about adverse effects, perceiving to be healthy, or actually believing natural immunity is better,’ he said.
 
‘A recommendation from [healthcare providers] normally offsets most of those things.’ 
 
In his summary, Associate Professor Litt emphasised the importance of the link between vaccine-preventable disease in older people and the position of the healthcare provider.
 
‘[Healthcare providers] have a very important role – they are the engine room,’ he said.
 
‘They are focused on the process and getting good outcomes, and implementation is really important as part of the core activity.’ 
 
The full video of Associate Professor Litt’s presentation at the APNA 2019 national conference is available on the RACGP website.



Green Book influenza prevention vaccination


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