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How effective are access, provider, system and societal interventions in increasing the uptake of influenza vaccination in people aged 60 years and older in the community?
Effective interventions for increasing community demand were a letter plus leaflet/postcard (compared with a letter), nurses/pharmacists educating plus vaccinating patients, a phone call from a senior, a telephone invitation rather than clinic drop-in, free groceries lottery and nurses educating and vaccinating patients. Effective interventions for enhancing vaccination access were home visits (compared with clinic invitation), free vaccine and patient group visits. Effective provider/system interventions were paying physicians, reminding physicians about all their patients, posters plus postcards, chart review/feedback and educational outreach/feedback.
Trials did not report adverse events. There were no trials of interventions at a societal level. A key problem was measuring how complete the assessment of influenza vaccination was, as in most of the US studies it was possible for participants to receive vaccination at walk-in clinics and during campaigns, instead of their regular clinics; some studies did not perform independent verification of the accuracy and completeness of their clinic records or financial billings.
Many health authorities recommend influenza vaccination of older people. However, vaccination uptake in people aged 60 and older varies across countries, socioeconomic and health-risk groups. It is important to identify effective interventions to increase influenza vaccination uptake.
Thomas RE, Lorenzetti DI. Interventions to increase influenza vaccination rates of those 60 years and older in the community. Cochrane Reviews, 2014, Issue 7. Art. No.: CD005188.DOI: 10.1002/14651858. CD005188.pub3. This review contains 57 studies involving 896,531 participants.
Cochrane Systematic Reviews for primary care practitioners
Developed by the Cochrane Primary Care Field, New Zealand Branch of the Australasian Cochrane Centre at the Department of General Practice and Primary Health Care, University of Auckland and funded by the Ministry of Health and New Zealand Doctor. PEARLS are meant for educational use and not to guide clinical care. New Zealanders can access the Cochrane Library free via www.cochrane.org.nz
Pharmacist prescribers Linda Bryant and Leanne Te Karu discuss positive polypharmacy for heart failure. Current evidence shows the intensive implementation of four medications offers the greatest benefit to most patients with heart failure, with significant reductions in cardiovascular mortality, heart failure hospitalisations and all-cause mortality
