Comment améliorer la couverture vaccinale du papillomavirus humain : propositions des médecins généralistes des Pyrénées-Atlantiques à partir de l'analyse de leur pratique

Abstract : Introduction: human papillomavirus (HPV) infection is the most prevalent sexually transmitted infection in the world. It is a prerequisite for the development of cancerous lesions at the anogenital level. Anti-HPV vaccination has been recommended since 2007. Immunisation coverage (CV) was 14% in 2015 with a target of 60% desired by the 2014- 2019 cancer plan. The objective of the study is to identify the barriers to HPV vaccination, the secondary objectives are to identify areas for improvement of the vaccination. Materials and methods: this is a quantitative descriptive survey of patients conducted from May 22 to June 31, 2018 in the form of an anonymous self-administered questionnaire to 350 generals practitioners's from the department of Pyrénées-Atlantiques drawn by lot. The doctors were contacted by phone or email and the questionnaire sent after collection of their consent. Results: 240 physicians agreed to participate in the study and 156 questionnaires were usable. The descriptive analysis identified three barriers to vaccination: the lack of information of the general population (80.1%), the global refusal of vaccination (79.5%) and the fear of the emergence of auto diseases immunes (MAIs) from patients / parents (69.2%). The subgroup analysis that compared the physicians who offered the vaccination (VJF) to those who did not (VJVP) had objectivity as a obstacle: the male sex (p = 0.0019), the lack of continuing medical education (p = 0.0052), lack of follow-up (p = 0.0097), fear of doctors' emergence of MIS (p = 0.0073), doubt about effectiveness vaccine (p <0.001), fear of the emergence of new oncogenic HPV (p = 0.02), pressure from the pharmaceutical industry (p = 0.0023) and patients not involved in vaccination (p = 0.036). An information campaign targeting the target population is the most important means identified to improve the CV. Conclusion: many obstacles to vaccination have been identified, in connection with the patients, the doctors or the vaccines themselves. The information of the target population is the better means to improve the CV.
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Master Thesis
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Mathilde Bruyère. Comment améliorer la couverture vaccinale du papillomavirus humain : propositions des médecins généralistes des Pyrénées-Atlantiques à partir de l'analyse de leur pratique. Médecine humaine et pathologie. 2019. ⟨dumas-02101489⟩

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