Knowledge, Attitudes and Beliefs of Older Canadians and Their Healthcare Providers Regarding Shingles Vaccine

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Knowledge, Attitudes and Beliefs of Older
Canadians and Their Healthcare Providers
Regarding Shingles Vaccine

• D Shaw, D Cravit S McNeil
• June 2, 2008

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Background

• Shingles (herpes zoster) carries a significant
  burden of disease particularly in those over
  60y
• 130,000 cases of shingles
• 360,000 health care visits
• 17,000 cases of post-herpetic neuralgia (PHN)
• 2,000 hospitalizations
• Contributes to 20 deaths
• Annual healthcare cost est 69 million
• Brisson M. J Infect. 2002

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Shingles Vaccine

• New live-attenuated vaccine against shingles
  (Zostavax?, Merck) to be approved in Canada in
  near future

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Objectives

• What is the perceived burden of illness of
  shingles among Canadians over 60y?
• Are older Canadians willing to receive the
  shingles vaccine?
• Are healthcare providers for older Canadians
  (family, internal, geriatrics, infectious
  diseases, dermatology) willing to recommend the
  shingles vaccine?
• Who do these groups think should pay for the
  shingles vaccine?

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Methods

• Surveys designed, tested for content validity and
  test-retest reliability and piloted
• Web-based survey emailed to members of the
  Canadian Association of Retired Persons aged ?
  60y
• Web-based and paper-based survey distributed to
  NS physicians- Family Medicine, Internal
  Medicine, Geriatrics, Dermatology, Infectious
  Diseases

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Results

• 603 older Canadian responses all Provinces and
  Territories represented
• 161 NS physician responses (25 response rate)
• No differences in main outcomes by age, gender,
  province/territory of residence (older),
  education (older), income (older), specialty of
  medicine (physician), years spent in practice
  (physician)

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Results Burden of Shingles

• 48 of older Canadians reported at least one
  episode of shingles
• 40 experienced PHN
• 82 older Canadians had friend/family member with
  shingles

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Results- Vaccine Acceptability

• 87 of older Canadians willing to receive the
  vaccine if safe and recommended by physician
• 87 think vaccine should be publicly funded for
  those over 60y
• 67 willing to pay out-of-pocket
• 93 of NS physicians indicated willing to
  recommend vaccine if it prevents shingles
• 94 of NS physicians think vaccine should be
  publicly funded for those over 60y

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Results- Factors associated with older Canadian
willingness to receive shingles vaccine
(regression)
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Results Variables associated with Physician
willingness to recommend shingles vaccine
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Summary

• Shingles associated with significant burden of
  illness
• Majority of older adults would accept vaccine if
  recommended by their physician (87)
• 93 of NS physicians responsible for healthcare
  of elderly intend to recommend shingles vaccine
• Majority of older adults (87) and physicians
  (94) believe that shingles vaccine should be
  publicly funded for older Canadians smaller
  majority of older Canadians willing to pay for
  shingles vaccine out-of-pocket

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Conclusion

• Demand for the shingles vaccine is likely to be
  high among older Canadians and their healthcare
  providers
• Careful consideration of program feasibility and
  cost effectiveness of publicly-funded shingles
  vaccine is warranted

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Acknowledgements

• Dalhousie Music-in-Medicine Program
• Capital Health Research Fund
• Brian Hoyt
• Petra Rykers
• Kimberly Brooks

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Questions