Ohta Ryuichi, Ryu Yoshinori, Sano Chiaki
Community Care, Unnan City Hospital, Unnan, JPN.
Community Medicine Management, Shimane University Faculty of Medicine, Izumo, JPN.
Cureus. 2025 Apr 20;17(4):e82615. doi: 10.7759/cureus.82615. eCollection 2025 Apr.
Pneumococcal infection is a significant cause of morbidity and mortality among older adults, with lasting impacts on daily functioning and frailty. Although pneumococcal vaccination is a proven preventive measure, uptake remains low in many primary care settings. This systematic review examined the effectiveness of interventions designed to increase pneumococcal vaccination uptake among older patients in primary care. A comprehensive literature search was conducted in PubMed, Embase, and Web of Science for studies published between January 1995 and April 2025. Studies eligible for inclusion were randomized controlled trials or quasi-experimental studies targeting individuals aged 65 or older. Out of 166 identified records, five studies met the inclusion criteria. Interventions varied widely, including low-literacy educational brochures, computerized physician reminder systems, mailed feedback, point-of-care flyers, and comprehensive system-level programs. All interventions positively affected vaccination uptake, with absolute increases ranging from 1.9% to 35% compared to controls. Strategies targeting healthcare providers, mainly through reminders and feedback mechanisms, tended to yield higher improvements. Only one study was conducted in Asia, indicating a significant gap in regional evidence. The findings suggest that simple and multicomponent interventions can effectively improve pneumococcal vaccination rates in older adults when implemented through primary care. Greater attention to interdisciplinary collaboration and the use of context-specific strategies is warranted. Further trials, particularly in Asian and resource-limited settings, are needed to inform sustainable, scalable approaches to increasing vaccination coverage.
肺炎球菌感染是老年人发病和死亡的一个重要原因，对日常功能和虚弱状态有持久影响。尽管肺炎球菌疫苗接种是一种经过验证的预防措施，但在许多初级保健机构中，疫苗接种率仍然很低。本系统评价考察了旨在提高初级保健中老年患者肺炎球菌疫苗接种率的干预措施的有效性。在PubMed、Embase和Web of Science上进行了全面的文献检索，以查找1995年1月至2025年4月发表的研究。纳入的研究为针对65岁及以上个体的随机对照试验或准实验研究。在166条识别记录中，有5项研究符合纳入标准。干预措施差异很大，包括低识字率教育手册、计算机化医生提醒系统、邮寄反馈、即时护理传单和综合系统层面的项目。与对照组相比，所有干预措施都对疫苗接种率产生了积极影响，绝对提高率在1.9%至35%之间。主要通过提醒和反馈机制针对医疗保健提供者的策略往往能取得更高的改善效果。只有一项研究在亚洲进行，这表明区域证据存在显著差距。研究结果表明，通过初级保健实施简单的多组分干预措施可以有效提高老年人的肺炎球菌疫苗接种率。需要更加关注跨学科合作和使用因地制宜的策略。需要进一步开展试验，特别是在亚洲和资源有限的环境中，以提供关于提高疫苗接种覆盖率的可持续、可扩展方法的信息。
