Background: Despite the benefits, immunisation coverage of older Australians is suboptimal. Uptake of some vaccines has even been falling in recent years. As adult immunisation occurs almost exclusively in primary care, general practice registrars are often the key health professionals involved.
Methods: A cross-sectional analysis of data from 2010-2019 collected as part of the Registrar Clinical Encounters in Training (ReCEnT) cohort study. General practice registrars collect data on 60 consecutive patient encounters per six-month training term. Univariate and multivariable regressions were conducted to detect associations between a recommended vaccine being prescribed and a number of patient, registrar, practice and consultation factors. The sample included patients aged ?65 years as well as Aboriginal and Torres Strait Islander patients aged ?50 years.
Results: The key patient predictors of lower odds of immunisation were: Aboriginal and/or Torres Strait Islander background (OR 0.69; 95% CI 0.49-0.96); those attending practices in outer regional, remote and very remote areas (OR 0.74; 95% CI 0.57-0.97 compared to major cities); and attending practices in areas of greater relative socioeconomic disadvantage (OR per decile 1.03; 95% CI 1.00-1.05). Patients who were new to the practice, or to the registrar had higher odds of receiving a recommended immunisation with Odds Ratios of 2.48 (95%CI 2.08-2.96) and 2.01 (95% CI 1.86-2.17), respectively.
Discussion: Although an exploratory study, these findings suggest that general practice registrars may be conducting thorough initial assessments with preventative health in mind. It also affirms the findings of previous studies regarding the determinants of aged immunisation.
Implications for practice: This study lays the foundations for improvements in GP registrar education around immunisation of the elderly. It also indicates that further study is required to explore how to improve immunisation provision to the most vulnerable older populations.