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RCT of Centralized Vaccine Reminder/Recall for Adults.
Am J Prev Med. 2018 08; 55(2):231-239.AJ

Abstract

INTRODUCTION

A proven, but underutilized, method to increase current low vaccination rates is reminder/recall. Centralized reminder/recall using an Immunization Information System reduces the burden of an individual practice conducting reminder/recall. The objectives were to assess the effectiveness of centralized vaccine reminder/recall on improving adult vaccination rates using Colorado's Immunization Information System.

STUDY DESIGN

This study is a pragmatic RCT.

SETTING/PARTICIPANTS

Denver Health patients were divided into three strata: 25,039 individuals aged 19-64 years without a high-risk condition for pneumococcal disease, 16,897 individuals aged 19-64 years with a high-risk condition, and 5,332 individuals aged ≥65 years. Data were collected from October 2015 to April 2016 and analyzed between September 2016 and June 2017.

INTERVENTION

Adults aged 19-64 years without a high-risk condition who needed influenza or tetanus, diphtheria, acellular pertussis vaccine or both, and adults with a high-risk condition and adults aged ≥65 years who needed influenza, or tetanus, diphtheria, acellular pertussis, or pneumococcal vaccine, or all three vaccines were randomized to receive up to three reminder/recalls or usual care.

MAIN OUTCOME MEASURES

Documentation of receipt of any needed vaccine in Immunization Information System ≤6 months after the reminder/recall was the primary outcome. A secondary outcome included implementation costs of the reminder/recall effort. A mixed effects model assessed the association between the intervention and receipt of any needed vaccine while controlling for gender, age, race, ethnicity, insurance type, and history of vaccine refusal.

RESULTS

The intervention was associated with receipt of any needed vaccine in the adults aged ≥65 years population (AOR=1.15, 95% CI=1.02, 1.30), but not the other two populations. Influenza vaccine was the source of this difference, with 32.0% receiving a vaccine in intervention versus 28.6% in usual-care groups (p≤0.01). Start-up and implementation costs per person were $0.86. In the population aged ≥65 years, 29.4 patients would need to be contacted to gain one additional vaccination.

CONCLUSIONS

Centralized reminder/recall was effective at increasing influenza vaccination rates in adults aged ≥65 years over a short time period, without burdening the practices, and at a reasonable cost.

TRIAL REGISTRATION

This study is registered at www.clinicaltrials.gov NCT02133391.

Authors+Show Affiliations

Adult and Child Consortium for Health Outcomes Research and Delivery Science, University of Colorado School of Medicine and Children's Hospital Colorado, Aurora, Colorado; Division of General Internal Medicine, Denver Health, Denver, Colorado. Electronic address: laura.hurley@dhha.org.Adult and Child Consortium for Health Outcomes Research and Delivery Science, University of Colorado School of Medicine and Children's Hospital Colorado, Aurora, Colorado; Department of Biostatistics, Colorado School of Public Health, University of Colorado, Aurora, Colorado.Adult and Child Consortium for Health Outcomes Research and Delivery Science, University of Colorado School of Medicine and Children's Hospital Colorado, Aurora, Colorado.Adult and Child Consortium for Health Outcomes Research and Delivery Science, University of Colorado School of Medicine and Children's Hospital Colorado, Aurora, Colorado.Ambulatory Care Services Data and Analytics, Denver Health, Denver, Colorado.Adult and Child Consortium for Health Outcomes Research and Delivery Science, University of Colorado School of Medicine and Children's Hospital Colorado, Aurora, Colorado; Department of Family Medicine, University of Colorado School of Medicine, Aurora, Colorado.Adult and Child Consortium for Health Outcomes Research and Delivery Science, University of Colorado School of Medicine and Children's Hospital Colorado, Aurora, Colorado; Department of Clinical Pharmacy, University of Colorado, Anschutz Medical Campus, Aurora, Colorado.Colorado Department of Public Health and Environment, Denver, Colorado.Adult and Child Consortium for Health Outcomes Research and Delivery Science, University of Colorado School of Medicine and Children's Hospital Colorado, Aurora, Colorado; Department of Pediatrics, University of Colorado School of Medicine, Aurora, Colorado.

Pub Type(s)

Journal Article
Randomized Controlled Trial
Research Support, U.S. Gov't, P.H.S.

Language

eng

PubMed ID

29910118

Citation

Hurley, Laura P., et al. "RCT of Centralized Vaccine Reminder/Recall for Adults." American Journal of Preventive Medicine, vol. 55, no. 2, 2018, pp. 231-239.
Hurley LP, Beaty B, Lockhart S, et al. RCT of Centralized Vaccine Reminder/Recall for Adults. Am J Prev Med. 2018;55(2):231-239.
Hurley, L. P., Beaty, B., Lockhart, S., Gurfinkel, D., Breslin, K., Dickinson, M., Whittington, M. D., Roth, H., & Kempe, A. (2018). RCT of Centralized Vaccine Reminder/Recall for Adults. American Journal of Preventive Medicine, 55(2), 231-239. https://doi.org/10.1016/j.amepre.2018.04.022
Hurley LP, et al. RCT of Centralized Vaccine Reminder/Recall for Adults. Am J Prev Med. 2018;55(2):231-239. PubMed PMID: 29910118.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - RCT of Centralized Vaccine Reminder/Recall for Adults. AU - Hurley,Laura P, AU - Beaty,Brenda, AU - Lockhart,Steven, AU - Gurfinkel,Dennis, AU - Breslin,Kristin, AU - Dickinson,Miriam, AU - Whittington,Melanie D, AU - Roth,Heather, AU - Kempe,Allison, Y1 - 2018/06/15/ PY - 2017/09/01/received PY - 2018/03/09/revised PY - 2018/04/10/accepted PY - 2018/6/19/pubmed PY - 2019/10/8/medline PY - 2018/6/19/entrez SP - 231 EP - 239 JF - American journal of preventive medicine JO - Am J Prev Med VL - 55 IS - 2 N2 - INTRODUCTION: A proven, but underutilized, method to increase current low vaccination rates is reminder/recall. Centralized reminder/recall using an Immunization Information System reduces the burden of an individual practice conducting reminder/recall. The objectives were to assess the effectiveness of centralized vaccine reminder/recall on improving adult vaccination rates using Colorado's Immunization Information System. STUDY DESIGN: This study is a pragmatic RCT. SETTING/PARTICIPANTS: Denver Health patients were divided into three strata: 25,039 individuals aged 19-64 years without a high-risk condition for pneumococcal disease, 16,897 individuals aged 19-64 years with a high-risk condition, and 5,332 individuals aged ≥65 years. Data were collected from October 2015 to April 2016 and analyzed between September 2016 and June 2017. INTERVENTION: Adults aged 19-64 years without a high-risk condition who needed influenza or tetanus, diphtheria, acellular pertussis vaccine or both, and adults with a high-risk condition and adults aged ≥65 years who needed influenza, or tetanus, diphtheria, acellular pertussis, or pneumococcal vaccine, or all three vaccines were randomized to receive up to three reminder/recalls or usual care. MAIN OUTCOME MEASURES: Documentation of receipt of any needed vaccine in Immunization Information System ≤6 months after the reminder/recall was the primary outcome. A secondary outcome included implementation costs of the reminder/recall effort. A mixed effects model assessed the association between the intervention and receipt of any needed vaccine while controlling for gender, age, race, ethnicity, insurance type, and history of vaccine refusal. RESULTS: The intervention was associated with receipt of any needed vaccine in the adults aged ≥65 years population (AOR=1.15, 95% CI=1.02, 1.30), but not the other two populations. Influenza vaccine was the source of this difference, with 32.0% receiving a vaccine in intervention versus 28.6% in usual-care groups (p≤0.01). Start-up and implementation costs per person were $0.86. In the population aged ≥65 years, 29.4 patients would need to be contacted to gain one additional vaccination. CONCLUSIONS: Centralized reminder/recall was effective at increasing influenza vaccination rates in adults aged ≥65 years over a short time period, without burdening the practices, and at a reasonable cost. TRIAL REGISTRATION: This study is registered at www.clinicaltrials.gov NCT02133391. SN - 1873-2607 UR - https://www.unboundmedicine.com/medline/citation/29910118/RCT_of_Centralized_Vaccine_Reminder/Recall_for_Adults_ L2 - https://linkinghub.elsevier.com/retrieve/pii/S0749-3797(18)31705-7 DB - PRIME DP - Unbound Medicine ER -