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

D Shaw, D Cravit & S McNeilJune 2, 2008

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

Shingles Vaccine

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

0 25 50 75 100

Vaccine Efficacy (%)

BOI

PHN

Zoster 95% CI

Objectives

1. What is the perceived burden of illness of shingles among Canadians over 60y?

2. Are older Canadians willing to receive the shingles vaccine?

3. Are healthcare providers for older Canadians (family, internal, geriatrics, infectious diseases, dermatology) willing to recommend the shingles vaccine?

4. Who do these groups think should pay for the shingles vaccine?

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

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)

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

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

Results- Factors associated with older Canadian willingness to receive shingles vaccine (regression)

Results: Variables associated with Physician willingness to recommend shingles vaccine

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

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

Acknowledgements

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

Questions