Attitudes and beliefs of Australian cardiologists on the role of seasonal influenza immunisation in cardiovascular care.

Abstract

Background Influenza immunisation reduces cardiovascular events among those with cardiovascular disease however uptake is poor. Clinician recommendation increases adoption of influenza immunisation in the general population, however the attitudes of Australian cardiologists to seasonal influenza immunisation are unknown. Methods We used an exploratory sequential mixed methods design; semi-structured interviews of 10 cardiologists identified themes for quantitative evaluation in an online survey. Questions explored (a) attitudes and behaviours regarding influenza immunisation, (b) engagement with colleagues and professional bodies and (c) preventative cardiac care. The survey was administered to 63 cardiologists between November 2020 and January 2021, and respondents received an honorarium for their time. Results The majority of respondents were general cardiologists (50/63)—compared with subspecialist cardiologists, with an average 21 years in practice. Less than half routinely asked about immunisation status (46%, 29/63). Only one quarter (25.4%, 16/63) recommended influenza immunisation to all of their patients while higher proportions recommended it to patients with ASCVD (49.2%, 31/63), heart failure (69.8%, 44/63) and those ≥65 years (68.3%, 44/63). Half (57.1%, 36/63) agreed that influenza immunisation was important/very important for prevention of cardiac events but was of lower priority compared with smoking cessation (100%, 63/63), anti-hypertensives (96.8%, 61/63), statins (94.3%, 60/63), exercise (80.9%, 51/63) and diet (68.2%, 43/63). Three quarters (76.2%, 48/63) believed the GP was responsible for immunisation and only 12.7% (8/63) reporting it was the cardiologist’s role. Conclusions Despite a relative risk reduction exceeding that of statins, influenza immunisation is not prioritised or recommended by cardiologists. Efforts at increasing awareness among cardiologists may assist in increasing uptake among CV patients.