title: Improving uptake of influenza vaccination among older people: a randomised controlled trial.
abstract: BACKGROUND
  The uptake of influenza vaccination among older people is suboptimal. Contact with a doctor or nurse is associated with older people deciding to accept influenza vaccination.
  
  
  OBJECTIVE
  To compare different forms of approach in improving uptake of influenza vaccination among patients aged 75 years and over in primary care.
  
  
  METHODS
  Randomised controlled trial.
  
  
  METHODS
  One large rural general practice serving the town and surrounding area of Melton Mowbray, Leicestershire.
  
  
  METHODS
  All 2,052 patients aged 75 years and over, registered with the practice and not living in nursing/residential homes or sheltered accommodation, were included in the study. One-third of patients were randomised to receive an offer of influenza vaccination as part of an over-75 health check administered by a practice nurse in the patient's home, and two-thirds of patients were randomised to receive a personal letter of invitation to attend an influenza vaccination clinic held at the surgery. The main outcome measure was uptake of influenza vaccination.
  
  
  RESULTS
  Six hundred and eighty patients were randomised to the health check arm of the trial and 1,372 were randomised to receive a personal letter. Of those randomised to the health check arm, 468 received the health check from the nurse. Overall, the difference in influenza vaccination uptake was 6.4% (95% confidence interval [CI] = 2.2% to 10.4%) with 67.9% (n = 932) of those who were sent a personal letter actually receiving the vaccine, compared with 74.3% (n = 505) of those offered a combined health check and influenza vaccination (P = 0.003).
  
  
  CONCLUSIONS
  Combining home-based over- 75 health checks with influenza vaccination can improve uptake among older patients. However this intervention is likely to be costly and its effect on influenza vaccination rates is modest. The difference in uptake is greater among those who do not routinely comeforwardfor vaccination and a more viable option may be to target these patients.
authors.affiliation: School of Nursing, Faculty of Medicine and Health Sciences, University of Nottingham. tony.arthur@nottingham.ac.uk
authors.forename: Antony J
authors.initials: AJ
authors.lastname: Arthur
authors.forename: Ruth J
authors.initials: RJ
authors.lastname: Matthews
authors.forename: Carol
authors.initials: C
authors.lastname: Jagger
authors.forename: Michael
authors.initials: M
authors.lastname: Clarke
authors.forename: Alison
authors.initials: A
authors.lastname: Hipkin
authors.forename: Dean P
authors.initials: DP
authors.lastname: Bennison
mesh_terms: D000368:Aged; D004739:England; D005260:Female; D006293:Health Promotion / Q000379:methods; D006699:Home Care Services / Q000458:organization & administration; D006801:Humans; D007252:Influenza Vaccines / Q000008:administration & dosage*; D007251:Influenza, Human / Q000517:prevention & control*; D008297:Male; D010342:Patient Acceptance of Health Care / Q000706:statistics & numerical data; D012423:Rural Health; D014611:Vaccination / Q000706:statistics & numerical data*
chemical_list: D007252:Influenza Vaccines