Department of Medicine, University of Mississippi Medical Center, Jackson, MS, USA.
Am J Med. 2010 Nov;123(11):1031-5. doi: 10.1016/j.amjmed.2010.06.017. Epub 2010 Sep 16.
Influenza morbidity and mortality remain high in the United States although vaccination clearly improves health outcomes and reduces health expenditures. This study was designed to assess the effectiveness of mail and telephone reminder strategies on improving existing clinic influenza vaccination rates among those not seeking early seasonal vaccination.
In mid-November, we randomized 1371 patients at a hypertension clinic into 1 of 2 intervention groups, a mail reminder group (letter plus the Centers for Disease Control [CDC] Influenza Vaccine Information Statement) or a phone reminder group (same information via a personal phone call), or a control group. The following spring, records were reviewed for vaccination documentation. Patients without documentation were contacted by phone to identify whether vaccination for the current season had been obtained.
The final analysis included 884 patients (62% women, mean age 57.2 years old): 325 in the mail reminder group, 246 in the phone reminder group, and 313 represented the control group. Overall, 388 of these patients (44%) were vaccinated. Vaccination rates were significantly higher in the intervention groups, 46% for the mail reminder group (age and sex adjusted odds ratio [OR], 1.8, 95% confidence interval [CI], 1.3-2.5; P=.001) and 56% for the phone reminder group (OR, 2.8; 95% CI, 1.9-4.0; P<.0001), compared to 33% in the control group. Both interventions increased vaccination rates in all age/sex groups.
In contrast to earlier studies, this intervention occurred later in the influenza vaccination period excluding those who seek early vaccination and allowing interventions to target those less likely to receive vaccination. Compared to previous studies demonstrating only trivial or modest benefits, both mail and phone reminders effectively increased clinic vaccination rates in our group of patients.
尽管疫苗接种明显改善了健康结果并降低了医疗支出，但流感发病率和死亡率在美国仍然很高。本研究旨在评估邮件和电话提醒策略对提高未及早接种季节性流感疫苗人群现有诊所流感疫苗接种率的有效性。
11 月中旬，我们将高血压诊所的 1371 名患者随机分为 2 个干预组之一，即邮件提醒组（信件加疾病控制与预防中心[CDC]流感疫苗信息声明）或电话提醒组（通过个人电话提供相同信息），或对照组。次年春天，回顾记录以获取疫苗接种证明。对于没有证明的患者，通过电话联系以确定是否接种了当前季节的疫苗。
最终分析包括 884 名患者（62%为女性，平均年龄为 57.2 岁）：邮件提醒组 325 名，电话提醒组 246 名，对照组 313 名。这些患者中共有 388 名（44%）接种了疫苗。干预组的接种率明显更高，邮件提醒组为 46%（年龄和性别调整后的优势比[OR]，1.8，95%置信区间[CI]，1.3-2.5；P=.001），电话提醒组为 56%（OR，2.8；95% CI，1.9-4.0；P<.0001），而对照组为 33%。两种干预措施都提高了所有年龄/性别组的疫苗接种率。
与早期研究相比，本研究的干预措施发生在流感疫苗接种期较晚的阶段，排除了那些寻求早期接种的人群，并使干预措施针对那些不太可能接种疫苗的人群。与之前仅显示微不足道或适度益处的研究相比，邮件和电话提醒都有效地提高了我们患者群体中诊所的疫苗接种率。
