title: Text messaging reminders for influenza vaccine in primary care: protocol for a cluster randomised controlled trial (TXT4FLUJAB).
abstract: BACKGROUND
  The UK government recommends that at least 75% of people aged under 64 with certain conditions receive an annual influenza vaccination. Primary care practices often fall short of this target and strategies to increase vaccine uptake are required. Text messaging reminders are already used in 30% of practices to remind patients about vaccination, but there has been no trial addressing their effectiveness in increasing influenza vaccine uptake in the UK. The aims of the study are (1) to develop the methodology for conducting cluster randomised trials of text messaging interventions utilising routine electronic health records and (2) to assess the effectiveness of using a text messaging influenza vaccine reminder in achieving an increase in influenza vaccine uptake in patients aged 18-64 with chronic conditions, compared with standard care.
  
  
  METHODS
  This cluster randomised trial will recruit general practices across three settings in English primary care (Clinical Practice Research Datalink, ResearchOne and London iPLATO text messaging software users) and randomise them to either standard care or a text messaging campaign to eligible patients. Flu vaccine uptake will be ascertained using routinely collected, anonymised electronic patient records. This protocol outlines the proposed study design and analysis methods.
  
  
  BACKGROUND
  This study will determine the effectiveness of text messaging vaccine reminders in primary care in increasing influenza vaccine uptake, and will strengthen the methodology for using electronic health records in cluster randomised trials of text messaging interventions. This trial was approved by the Surrey Borders Ethics Committee (13/LO/0872). The trial results will be disseminated at national conferences and published in a peer-reviewed medical journal. The results will also be distributed to the Primary Care Research Network and to all participating general practices.
  
  
  BACKGROUND
  This study is registered at controlled-trials.com ISRCTN48840025, July 2013.
authors.affiliation: London School of Hygiene and Tropical Medicine, London, UK.
authors.forename: Emily
authors.initials: E
authors.lastname: Herrett
authors.forename: Tjeerd
authors.initials: T
authors.lastname: van Staa
authors.forename: Caroline
authors.initials: C
authors.lastname: Free
authors.forename: Liam
authors.initials: L
authors.lastname: Smeeth
mesh_terms: D057286:Electronic Health Records; D058006:General Practice; D006801:Humans; D007252:Influenza Vaccines; D011320:Primary Health Care; D017010:Reminder Systems; D012107:Research Design; D060145:Text Messaging; D014611:Vaccination
chemical_list: D007252:Influenza Vaccines
keywords: Epidemiology; Preventive Medicine; Primary Care