RCT of Centralized Vaccine Reminder/Recall for Adults
RCT of Centralized Vaccine Reminder/Recall for Adults
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DOI：
10.1016/j.amepre.2018.04.022
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发表时间：
2018-08-01
影响因子：
5.5
通讯作者：
Kempe, Allison
中科院分区：
文献类型：
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作者：
Hurley, Laura P.;Beaty, Brenda;Kempe, Allison
引言：提醒/召回是一种行之有效但未得到充分利用的方法，可以提高目前较低的疫苗接种率。使用免疫信息系统的集中提醒/召回减少了进行提醒/召回的个人做法的负担。研究目的是评估集中疫苗提醒/召回在利用科罗拉多州免疫信息系统提高成人疫苗接种率方面的有效性。研究设计：这项研究是一项务实的随机对照试验。设置/参与者：丹佛健康患者被分为三个层次：25,039名年龄在19岁-之间的非肺炎球菌病高危人群，16,897名年龄在19-岁之间的高危人群，以及5,332名年龄=65岁的人群。资料收集自2015年10月至2016年4月，分析时间为2016年9月至2017年6月。干预：19~岁无流感、破伤风、白喉、无细胞百日咳疫苗或两者兼有的高危人群，高危人群和老年人群；=65岁需要流感、破伤风、白喉、无细胞百日咳、肺炎球菌疫苗，或所有这三种疫苗的人随机接受最多三次提醒/召回或常规护理。主要观察指标：免疫信息系统中任何需要接种疫苗的文件=65岁人群(AOR=1.15，95%CI=1.02，1.30)，但其他两个人群不接受。流感疫苗接种是造成这一差异的原因，干预中接种流感疫苗的比例为32.0%，而常规护理组为28.6%(p=65岁，需要联系29.4名患者才能再接种一次。结论：集中提醒/召回在短时间内有效地提高了65岁成年人的流感疫苗接种率，而不增加实践的负担，而且成本合理。
Introduction: A proven, but underutilized, method to increase current low vaccination rates is reminder/recall. Centralized reminder/recall using an Immunization Information System reduces the burden of an individual practice conducting reminder/recall. The objectives were to assess the effectiveness of centralized vaccine reminder/recall on improving adult vaccination rates using Colorado's Immunization Information System.Study design: This study is a pragmatic RCT.Setting/participants: Denver Health patients were divided into three strata: 25,039 individuals aged 19-64 years without a high-risk condition for pneumococcal disease, 16,897 individuals aged 19-64 years with a high-risk condition, and 5,332 individuals aged >= 65 years. Data were collected from October 2015 to April 2016 and analyzed between September 2016 and June 2017.Intervention: Adults aged 19-64 years without a high-risk condition who needed influenza or tetanus, diphtheria, acellular pertussis vaccine or both, and adults with a high-risk condition and adults aged >= 65 years who needed influenza, or tetanus, diphtheria, acellular pertussis, or pneumococcal vaccine, or all three vaccines were randomized to receive up to three reminder/recalls or usual care.Main outcome measures: Documentation of receipt of any needed vaccine in Immunization Information System = 65 years population (AOR=1.15, 95% CI=1.02, 1.30), but not the other two populations. Influenza vaccine was the source of this difference, with 32.0% receiving a vaccine in intervention versus 28.6% in usual-care groups (p = 65 years, 29.4 patients would need to be contacted to gain one additional vaccination.Conclusions: Centralized reminder/recall was effective at increasing influenza vaccination rates in adults aged >= 65 years over a short time period, without burdening the practices, and at a reasonable cost.