Increasing influenza vaccination rates among healthcare workers by focusing on workplace and patient safety

Context: In 2014, the influenza vaccine uptake in Europe was below 35% among healthcare workers (HCWs). Due to a lack of confidence in vaccination as a result of safety concerns, HCWs increasingly do not take the influenza vaccine. Consequently, there is a rising influenza burden which results in increasing mortality of vulnerable patients and absenteeism in hospitals. This policy brief aims to increase the awareness of HCWs regarding the importance of influenza vaccination uptake, which may result in improved patient and workplace safety. Policy Options: To increase vaccination coverage and reduce vaccine hesitancy among HCWs, a change in attitude towards and knowledge about the influenza vaccine is needed. Two potential approaches are presented in this paper. Firstly, a mandatory vaccination policy is discussed. Practical and ethical challenges of implementing a mandatory vaccination policy are considered.  Secondly, information campaigns are described, consisting of three pillars: safety, information, and knowledge. Recommendations: It is recommended to initiate information campaigns focussing on patient safety. Furthermore, a structural approach to increase access to vaccination at the workplace must be taken. Higher vaccination rates of HCWs lead to an improved workplace safety. The recommended information campaign can also be used for other vaccine preventable diseases or in other situations, such as HCWs vaccine hesitancy regarding COVID-19 vaccines. Lessons from the COVID-19 pandemic regarding acceptance of vaccines should be considered for the improvement of future influenza vaccine uptake. Acknowledgments:  We would like to thank Kasia Czabanowska for the opportunity to develop this policy brief and Timo Clemens for his guidance and extensive feedback during the writing process &nbsp

Analysis of Drug and Health Resource Use Before and After COVID-19 Lockdown in a Population Undergoing Treatment for Depression or Anxiety

IntroductionThe arrival of the COVID-19 pandemic modified the functions of Primary Care (PC) teams, which were forced to focus their resources on the diagnosis and treatment of SARS-CoV-2 infected patients. The disrupted healthcare of individuals with pre-existing mental disorders (depression or anxiety), as well as the psychological decompensation resulting from the lockdown caused by the COVID-19 pandemic, may have modified the use of drugs and health resources by these patients. The aim of this study is to determine the changes in these parameters, between the 6 months prior to the lockdown (09/14/2019 to 03/15/2020) and the 6 months following its end (05/03/2020 to 11/04/2020), in a population undergoing active treatment for depression or anxiety, according to the electronic clinical record.Materials and MethodsReal world data observational study of 110,694 individuals aged >16 years suffering from active or undergoing treatment for depression or anxiety according to the electronic medical records of the Aragon Regional Health Service (Spain). Pharmacological variables [daily dose per inhabitant (DHD) dispensed by pharmacies of: anxiolytics, hypnotics/sedatives, and antidepressants] and variables related to the use of healthcare resources (number of primary and specialized healthcare visits) were considered. Student’s T-tests for paired samples were performed to analyze differences between periods (pre–post). The level of significance was established at 5% (p < 0.05).ResultsThe use of anxiolytic drugs increased as compared to its use over the 6 months prior to the lockdown. In contrast, the consumption of antidepressants was found to decrease. The use of health resources continued to be below pre-pandemic levels, 6 months post-lockdown end.ConclusionChanges in the use of health resources could have a negative impact on the parameters of these diseases. The increase in drug use, especially benzodiazepines, may suggest a worsening of the symptoms during the lockdown and in the subsequent months. It is a worrying sign, which points to the growth of this public health problem and the need for its prevention

Increasing influenza vaccination rates among healthcare workers by focusing on workplace and patient safety

Context: In 2014, the influenza vaccine uptake in Europe was below 35% among healthcare workers (HCWs). Due to a lack of confidence in vaccination as a result of safety concerns, HCWs increasingly do not take the influenza vaccine. Consequently, there is a rising influenza burden which results in increasing mortality of vulnerable patients and absenteeism in hospitals. This policy brief aims to increase the awareness of HCWs regarding the importance of influenza vaccination uptake, which may result in improved patient and workplace safety.   Policy Options: To increase vaccination coverage and reduce vaccine hesitancy among HCWs, a change in attitude towards and knowledge about the influenza vaccine is needed. Two potential approaches are presented in this paper. Firstly, a mandatory vaccination policy is discussed. Practical and ethical challenges of implementing a mandatory vaccination policy are considered.  Secondly, information campaigns are described, consisting of three pillars: safety, information, and knowledge.   Recommendations: It is recommended to initiate information campaigns focussing on patient safety. Furthermore, a structural approach to increase access to vaccination at the workplace must be taken. Higher vaccination rates of HCWs lead to an improved workplace safety. The recommended information campaign can also be used for other vaccine preventable diseases or in other situations, such as HCWs vaccine hesitancy regarding COVID-19 vaccines. Lessons from the COVID-19 pandemic regarding acceptance of vaccines should be considered for the improvement of future influenza vaccine uptake.   Acknowledgments:  We would like to thank Kasia Czabanowska for the opportunity to develop this policy brief and Timo Clemens for his guidance and extensive feedback during the writing process   Authors’ contributions: All authors contributed equally to this work.   Conflict of interest: None declared   Source of funding: None declare

Evaluating the validity of the French version of the Four-Dimensional Symptom Questionnaire with differential item functioning analysis

Background. GPs are daily confronted with mental disorders and psychosomatic problems. The Four-Dimensional Symptom Questionnaire (4DSQ), measuring distress, depression, anxiety and somatization, was purposively developed for primary care. It has been translated into 12 languages and is commonly used in several countries. It was translated into French in 2008, by forward and backward translation, but it has not been validated for a primary care population. Aim. This study aimed to establish whether the French 4DSQ measured the same constructs in the same way as the original Dutch 4DSQ. Method. Two samples of French general practice patients were recruited during routine care to obtain as much variability as possible. One sample included consecutive patients, from the waiting room of rural GPs, over a period of 2 weeks and the other sample included patients with suspected psychological problems or unexplained symptoms. This population was compared to a matched Dutch sample using confirmatory factor analysis (CFA) and differential item functioning (DIF) analysis. Results. A total of 231 patients, from 15 French GPs, completed the questionnaire (Dutch reference group: 231). Mean age was 42.9 years (Dutch: 42.1); females numbered 71% in both samples. The multigroup CFA assessed configural invariance of one-factor models per 4DSQ scale. Thirteen of the total of 50 items in the 4DSQ, in three scales, were detected with DIF. However, DIF did not impact on the scale scores. Conclusion. French 4DSQ scales have the same latent structures and measure the same traits as the original Dutch 4DS

Effect of early intervention for early-stage psychotic disorders on suicidal behaviours – a systematic review protocol

BackgroundThe early stages of psychotic disorders correspond to the early phases of the disease and include the prodromal phase and first-episode psychosis; they constitute a period at high risk of suicidal behaviour. A long duration of untreated psychosis (DUP) is among the risk factors of suicidal behaviour identified in this early period. Many studies have shown the effectiveness of early interventions on the overall prognosis of psychotic disorders in the early stages, and early intervention strategies have been developed and tested worldwide. Several authors reported an improvement in suicidal behaviours; however, all these data have not been systematically analysed yet. The main objective of this systematic review was to collect evidence on the effect on suicidal behaviour of early interventions for patients in the early stages of psychotic disorders.MethodsWe will carry out a systematic review of the literature according to the PRISMA criteria by searching articles in five databases (PubMed, Cochrane, PsycINFO, Scopus, EMBASE), without restriction on the publication date. The selection criteria are: articles (any type; e.g. prospective, retrospective, controlled or uncontrolled, and literature reviews) on early interventions for psychotic disorders in the early stages with data on suicide attempts, death by suicide, suicidal ideation; articles written in English or French. Exclusion criteria are: articles on suicidal behaviours in patients with psychotic disorders in the early stages, but without early intervention, and articles on early-stage psychotic disorders without data on suicidal behaviours.DiscussionIf this review confirms the effectiveness on suicidal behaviours of early interventions for young patients with psychotic disorders, the development/implementation of such intervention programmes should be better promoted.Systematic review registrationhttps://www.crd.york.ac.uk/prospero/, identifier CRD42021237833

Audit about Medical Decision: Data Transmission Concerning Patients with Dementia Entering French Nursing Homes Does Not Confirm the Diagnosis

Background. Dementia was affecting 855.000 patients in France in 2007. Lanmeur's rural hospital population was representative of the French nursing home's population. The followup was assumed by local GPs, which is also usual care in France for nursing homes. The study looked at clinical and paraclinical data transmitted at the institutionalization time of patients suffering from dementia. Aim. showing that admission letters did allow establishing a diagnosis of dementia for the GPs. Method. we included all patients with dementia at the time of institutionalization between July 2000 and July 2007. We searched in the admission letters for 25 criteria extracted from the French guidelines for dementia and Alzheimer disease diagnosis (multiple cross-sectional analysis per year). Results. 293 patients were included. The median number of diagnostic criteria present in the letters of admission is 1 (first quartile: zero, third quartile: 4, and maximum: 12). Conclusions. the data in admission letters did not allow the diagnosis of dementia according to the French guidelines. We know that dementia is underchecked and undertreated in France according to the same guidelines. What consequences did this lack of basic data give on motivation for treatment and recurrent diagnosis process for GPs? This has to be evaluated