title: The effect of various types of patients' reminders on the uptake of pneumococcal vaccine in adults: A randomized controlled trial.
abstract: BACKGROUND
  Invasive pneumococcal disease is one of the most important vaccine-preventable diseases threatening the adult community due to missed opportunities for vaccination. This study compares the effect of three different types of patient reminder system on adulthood Streptococcus pneumoniae immunization in a primary care setting.
  
  
  METHODS
  The study targeted patients aged 40 and older eligible for pneumococcal vaccine, but did not receive it yet (89.5% of 3072 patients) based on their electronic medical records in a family medicine center in Beirut. The sample population was randomized using an automated computer randomization system into six equal groups, receiving short phone calls, short text messaging system (sms-text) or e-mails each with or without patient education. Each group received three identical reminders spaced by a period of four weeks. Documentation of vaccine administration was then added to the longitudinal electronic patient record. The primary outcome was the vaccine administration rate in the clinics.
  
  
  RESULTS
  Of the eligible patients due for the pneumococcal 23-polyvalent vaccine, 1380 who had mobile phone numbers and e-mails were randomized into six equal intervention groups. The various reminders increased vaccination rate to 14.9%: 16.5% of the short phone calls group, 7.2% of the sms-text group and 5.7% of the e-mail group took the vaccine. The vaccination rate was independent of the age, associated education message and the predisposing condition.
  
  
  CONCLUSIONS
  Use of electronic text reminders via e-mails and mobile phones seems to be a feasible and sustainable model to increase pneumococcal vaccination rates in a primary care center.
authors.affiliation: Department of Family Medicine, American University of Beirut Medical Center (AUBMC), PO Box 11-0236, Riad El Solh, 1107-2020 Beirut, Lebanon. Electronic address: ag37@aub.edu.lb.
authors.forename: Alexandra S
authors.initials: AS
authors.lastname: Ghadieh
authors.affiliation: Department of Family Medicine, American University of Beirut Medical Center (AUBMC), PO Box 11-0236, Riad El Solh, 1107-2020 Beirut, Lebanon. Electronic address: ghamadeh@aub.edu.lb.
authors.forename: Ghassan N
authors.initials: GN
authors.lastname: Hamadeh
authors.affiliation: Department of Family Medicine, American University of Beirut Medical Center (AUBMC), PO Box 11-0236, Riad El Solh, 1107-2020 Beirut, Lebanon. Electronic address: dmm11@aub.edu.lb.
authors.forename: Dina M
authors.initials: DM
authors.lastname: Mahmassani
authors.affiliation: Department of Family Medicine, American University of Beirut Medical Center (AUBMC), PO Box 11-0236, Riad El Solh, 1107-2020 Beirut, Lebanon. Electronic address: ne23@aub.edu.lb.
authors.forename: Najla A
authors.initials: NA
authors.lastname: Lakkis
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D040421:Cell Phone; D057286:Electronic Health Records; D034742:Electronic Mail; D005260:Female; D006801:Humans; D007861:Lebanon; D008297:Male; D008875:Middle Aged; D011008:Pneumococcal Infections / Q000517:prevention & control*; D022242:Pneumococcal Vaccines / Q000008:administration & dosage*; D011446:Prospective Studies; D017010:Reminder Systems; D060145:Text Messaging; D014611:Vaccination / Q000706:statistics & numerical data*
chemical_list: D022242:Pneumococcal Vaccines
keywords: Patient's reminders; Pneumococcal 23-polyvalent vaccine; Short phone call; Sms-text, E-mail