Promoting influenza vaccination of elderly patients in primary care.
BACKGROUND
Though influenza is a serious health problem for elderly people, their influenza vaccination rate remains low in Switzerland.


OBJECTIVE
Our aim was to assess the impact of an intervention combining multiple strategies to promote influenza vaccination of elderly patients in primary care.


METHODS
We conducted a pre-/post-intervention study in a university-based primary care clinic in Geneva, Switzerland, where an annual community-wide campaign promotes influenza vaccination of people at high risk. We included 318 and 346 patients aged over 64 years attending the clinic during the last trimesters of 1995 and 1996, respectively. The intervention included: patient information by leaflets and posters, a walk-in vaccination clinic, a training workshop for physicians, record reminders and peer comparison feedback on vaccination performance. Using the computerized database, medical records and the vaccination register, we measured influenza immunization rates and relative benefits (RBs) of the intervention.


RESULTS
Influenza vaccine uptake globally increased from 21.7% before the intervention to 51.7% thereafter. Among 144 patients attending in both phases, the immunization rate rose from 29.2 to 69.4% [matched RB estimate (<RB>) = 2.4; 95% confidence interval (CI) 1.9-3.0]; vaccine uptake increased particularly among all chronic patients (<RB> = 3.2; 95% CI 2.2-4.6), cardiac patients (<RB> = 3.4; 95% CI 2.1-5.4) and diabetics (<RB> = 3.3; 95% CI 1.9-5.9). For 376 patients attending in a single phase, the vaccination rate rose from 15.5 to 39.1% (adjusted RB = 2.8; 95% CI 1.8-4.4), particularly among the elderly aged 65-75 years (adjusted RB = 5.7; 95% CI 2.7-12.4).


CONCLUSIONS
An intervention combining strategies targeting patients, physicians and care delivery significantly increased influenza vaccine uptake of elderly patients in primary care, particularly those at high risk.
Humair
Jean-Paul
JP
Department of Community Medicine, Geneva University Hospital, 24 Rue Micheli-du-Crest, CH-1211 Geneva 14, Switzerland. Jean-Paul.Humair@hcuge.ch
Buchs
Cristina Rizzi
CR
Stalder
Hans
H
D000368:Aged; D000369:Aged, 80 and over; D000553:Ambulatory Care; D005260:Female; D006293:Health Promotion; D006801:Humans; D017589:Immunization Programs / Q000706:statistics & numerical data*; D007252:Influenza Vaccines; D007251:Influenza, Human / Q000517:prevention & control*; D008297:Male; D010044:Outpatient Clinics, Hospital; D011320:Primary Health Care; D013557:Switzerland
D007252:Influenza Vaccines