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手机短信对提高罕见病患者流感疫苗接种率的影响。

Effect of mobile phone text messaging for improving the uptake of influenza vaccination in patients with rare diseases.

机构信息

Servicio de Informes de Salud y Estudios, Subdirección General de Epidemiología, Dirección General de Salud Pública, Autonomous Community of Madrid, Spain.

Servicio de Informes de Salud y Estudios, Subdirección General de Epidemiología, Dirección General de Salud Pública, Autonomous Community of Madrid, Spain.

出版信息

Vaccine. 2019 Aug 23;37(36):5257-5264. doi: 10.1016/j.vaccine.2019.07.062. Epub 2019 Jul 25.

Abstract

OBJECTIVES

Influenza vaccine is recommended in some chronic medical conditions, including several rare diseases. The objectives of the study were to assess the effect of text message reminders on influenza vaccination uptake of patients with selected rare diseases and delayed vaccination, and to describe their characteristics.

METHODS

Quasi-experimental pre-post intervention study performed along the 2016 influenza vaccination campaign in the Autonomous Community of Madrid. Unvaccinated patients diagnosed with a selected rare disease were targeted for intervention. SMS were sent to them at least one month after the beginning of the campaign, in four consecutive weeks. Those with no mobile phones available or no certainty of message reception, were assigned as controls. The association between the reception of the SMS and vaccination uptake was assessed using multiple poisson regression models.

RESULTS

Of 69.040 patients with delayed vaccination, 87.2% received an SMS reminder in the asigned contact mobile telephone. Global influenza vaccine coverage reached 41.3%. The uptake of influenza vaccine was significantly higher among those receiving the reminder (9.3% vs. 7.1% in the control group, p < 0.001). Those who received a SMS reminder were 30% more likely to uptake seasonal influenza vaccine. By sex and age, the reception of the reminder was associated with a significantly higher probability of vaccination in men ≥65 years with at least a concurrent chronic condition (IRR: 1.58, CI95%: 1.25-2.00). Among women, this higher probability was detected in those between 14 and 64 years of age (IRR: 1.41, CI95%: 1.22-1.63), and ≥65 years without concurrent chronic conditions (IRR: 1.40, CI95%: 1.05-1.89).

CONCLUSION

Although the intervention was modestly effective, it proved beneficial in some cases. It can be an additional strategy to improve vaccine uptake, since it is simple, feasible, affordable and easily scalable, particularly when immunization and target population data are available in population registries.

摘要

目的

流感疫苗在某些慢性疾病中被推荐使用,包括一些罕见病。本研究的目的是评估短信提醒对选定的罕见病患者和延迟接种流感疫苗的影响,并描述其特征。

方法

在马德里自治区 2016 年流感疫苗接种活动期间进行了一项准实验性前后干预研究。目标人群为未接种疫苗且患有选定罕见病的患者。在接种活动开始后至少一个月,以四周为一个周期,向他们发送短信。那些没有手机或无法确定是否收到短信的患者被分配为对照组。使用多泊松回归模型评估短信接收与疫苗接种率之间的关联。

结果

在 69040 名延迟接种疫苗的患者中,87.2%的人在指定的联系手机上收到了短信提醒。全球流感疫苗覆盖率达到 41.3%。接受提醒的患者接种流感疫苗的比例明显更高(提醒组为 9.3%,对照组为 7.1%,p<0.001)。收到短信提醒的患者接种季节性流感疫苗的可能性增加了 30%。按性别和年龄分层,在≥65 岁且至少合并一种慢性疾病的男性中,接收提醒与接种疫苗的概率显著增加(IRR:1.58,95%CI:1.25-2.00)。在女性中,这种更高的概率出现在 14 至 64 岁之间的人群中(IRR:1.41,95%CI:1.22-1.63),以及≥65 岁且无合并慢性疾病的人群中(IRR:1.40,95%CI:1.05-1.89)。

结论

尽管干预效果有限,但在某些情况下仍有益处。由于其简单、可行、经济实惠且易于扩展,尤其是在人群登记处可获得免疫接种和目标人群数据的情况下,它可以成为提高疫苗接种率的一种额外策略。

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