title: A randomised, clinical trial comparing the effectiveness of hospital and community-based reminder systems for increasing uptake of influenza and pneumococcal vaccine in hospitalised patients aged 65 years and over.
abstract: Hospitalisation represents an opportunity to identify unimmunised people at risk for the complications of influenza and pneumococcal disease. We conducted a randomised controlled trial of two strategies to increase uptake of influenza and pneumococcal vaccines in eligible, hospitalised subjects aged 65 years or more, admitted between May and September 1998 to a Melbourne hospital. Unvaccinated participants were allocated randomly to alert systems for hospital staff or community general practitioners (GPs). Follow-up occurred at 1 and 3 months. The baseline vaccination rates were 70% for influenza (426/606) and 41% (248/606) for pneumococcal disease. For unvaccinated subjects, the hospital alert resulted in 67% uptake compared to 55% following a GP alert for pneumococcal vaccine; and 63% in hospital compared to 53% following a GP alert for influenza vaccine. Although there was a trend toward a higher uptake in hospital, neither of these differences was statistically significant. The majority (75%) of vaccinations following a GP alert occurred within 1 month of discharge. Despite hospital and community-based reminder systems, there are still significant missed opportunities for vaccination. We did not demonstrate significant differences between hospital and GP reminder systems, but there was a trend towards higher uptake with opportunistic vaccination in hospital.
authors.affiliation: Victorian Infectious Diseases Service, The Royal Melbourne Hospital, Parkville, Australia. RainaM@chw.edu.au
authors.forename: C R
authors.initials: CR
authors.lastname: MacIntyre
authors.forename: M A
authors.initials: MA
authors.lastname: Kainer
authors.forename: G V
authors.initials: GV
authors.lastname: Brown
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D001315:Australia; D005260:Female; D006266:Health Education; D006801:Humans; D007252:Influenza Vaccines; D007297:Inpatients / Q000523:psychology* / Q000706:statistics & numerical data; D008297:Male; D010342:Patient Acceptance of Health Care / Q000523:psychology*; D022242:Pneumococcal Vaccines; D014611:Vaccination
chemical_list: D007252:Influenza Vaccines; D022242:Pneumococcal Vaccines