Use of an automated pharmacy system and patient registries to recruit HMO enrollees for an influenza campaign.
OBJECTIVE
To develop methods to identify, recruit, and vaccinate HMO enrollees at increased risk for influenza-related complications as part of a comprehensive influenza campaign.


METHODS
Group Health Cooperative (GHC) is a large, membership-governed, managed care organization that serves 395,000 members in the Puget Sound area.


METHODS
An automated pharmacy system and patient data registries were used to identify enrollees with chronic illness. Enrollees with chronic illness and all enrollees 65 years of age and older were considered "high-risk" enrollees to be recruited for vaccination. Postcard reminders coupled with a publicity and education campaign were used to recruit high-risk enrollees to special influenza clinics.


RESULTS
Our approach identified 2.5% of children (persons < 18 years of age) and 10.5% of adults (persons 18 to 65 years of age) as chronically ill and thus at high risk for influenza-related complications. Most high-risk children were identified through prescriptions for steroids, autonomic inhalers, or both or because they were enrolled in the asthma registry. Most high-risk adults were identified because of prescriptions for steroids, insulin, or oral hypoglycemic agents; because they had received pneumococcal vaccine; or because they were enrolled in the diabetes registry. Influenza coverage rates for all seniors (persons > or = 65 years of age) increased from 34% in 1984 to more than 72% in the 1996-1997 campaign year. Coverage rates were much lower for high-risk children (36%) and adults (46%).


CONCLUSIONS
Influenza coverage rates can still be substantially improved for adults younger than 65 years of age and children at high risk for influenza-related complications.
Pearson
D
D
Group Health Cooperative of Puget Sound, Seattle, WA, USA.
Jackson
L A
LA
Winkler
B
B
Foss
B
B
Wagener
B
B
D000293:Adolescent; D000328:Adult; D000368:Aged; D000465:Algorithms; D002648:Child; D002908:Chronic Disease; D016303:Clinical Pharmacy Information Systems; D006279:Health Maintenance Organizations / Q000458:organization & administration*; D006801:Humans; D017589:Immunization Programs / Q000458:organization & administration*; D007252:Influenza Vaccines / Q000008:administration & dosage*; D008875:Middle Aged; D018579:Patient Selection; D012042:Registries; D017010:Reminder Systems; D012307:Risk Factors; D014861:Washington
D007252:Influenza Vaccines