Improving influenza vaccination rates in the elderly - JFP Online - Abstract

Journal of Family Practice, Oct, 2002 by Myriam Birchmeier, Bernard Favrat, Alain Pecoud, Gilbert Abetel, Michel Karly, Pierre Landry, Maxime Mancini, Francois Verdon, Blaise Genton

* BACKGROUND Vaccination coverage for influenza in elderly remains low when the physician is the only person responsible for immunization. Integration of other health care workers may improve the coverage rate of at-risk groups.

* OBJECTIVES To estimate vaccination coverage rate using a strategy based on the systematic intervention of a health care professional proposing vaccination prior to the doctor's consultation; to evaluate the changes in coverage rates before and after introduction of this strategy; and to assess the feasibility of this intervention and the achieved coverage rate in family physician offices.

* STUDY DESIGN Prospective study in a medical outpatient clinic and 5 family physician practices in Switzerland.

* POPULATION Participants consisted of all patients [greater than or equal to] 65 years attending a medical outpatient clinic during the vaccination period in 1999 (n = 401); patients [greater than or equal to] 65 years regularly followed at a medical outpatient clinic in 1998 and 1999 (n = 195); and patients [greater than or equal to] 65 years presenting to 5 family physician offices in 1999 (n = 598).

* OUTCOME MEASURED Rates of vaccination coverage.

* RESULTS Among all participants, vaccination coverage in 1999 was 85% at a medical outpatient clinic and 83% in family physician offices. Among participants regularly followed at the medical outpatient clinic, vaccination coverage increased from 48% in 1998 to 76% in 1999. Rate of refusal was 9% at the medical outpatient clinic and 14% in the family physician offices.

* CONCLUSIONS The systematic intervention of a health care professional to suggest vaccination before the doctor's visit is an effective measure to achieve high coverage rate. Such a strategy also improves outpatient clinic or private practice efficiency by reducing pressures on physicians.

MYRIAM BIRCHMETER, MD; BERNARD FAVRAT, MD; ALAIN PECOUD, MD; GILBERT ABETEL, MD; MICHEL KARLY, MD: PIERRE LANDRY, MD; MAXIME MANCINI. MD; FRANCOIS VERDON. MD; AND BLAISE GENTON, MD, PHD Lausanne and Neuchatel, Switzerland