Effectiveness of patient reminders on influenza vaccination coverage among adults with chronic conditions: A feasibility study in Australian general practices

David Gonzalez-Chica; Oliver Frank; Jessie Edwards; Elizabeth Hoon; Carla de Oliveira Bernardo; Anton Knieriemen; Nigel Stocks

doi:10.1016/j.ypmed.2024.107983

Effectiveness of patient reminders on influenza vaccination coverage among adults with chronic conditions: A feasibility study in Australian general practices

Prev Med. 2024 May 1:184:107983. doi: 10.1016/j.ypmed.2024.107983. Online ahead of print.

Authors

David Gonzalez-Chica¹, Oliver Frank², Jessie Edwards², Elizabeth Hoon², Carla de Oliveira Bernardo², Anton Knieriemen³, Nigel Stocks²

Affiliations

¹ Discipline of General Practice, Adelaide Medical School, University of Adelaide, Adelaide, Australia; Adelaide Rural Clinical School, University of Adelaide, Adelaide, Australia. Electronic address: david.gonzalez@adelaide.edu.au.
² Discipline of General Practice, Adelaide Medical School, University of Adelaide, Adelaide, Australia.
³ Doctors Control Panel, Melbourne, Australia.

PMID: 38701953
DOI: 10.1016/j.ypmed.2024.107983

Abstract

Background: Influenza vaccination is recommended for Australians 18+ years old with medical risk factors, but coverage is suboptimal. We aimed to examine whether automatic, opportunistic patient reminders (SMS and/or printed) before appointments with a general practitioner increased influenza vaccination uptake.

Methods: This clustered non-randomised feasibility study in Australian general practice included patients aged 18-64 years with at least one medical risk factor attending participating practices between May and September 2021. Software installed at intervention practices identified unvaccinated eligible patients when they booked an appointment, sent vaccination reminders (SMS on booking and 1 h before appointments), and printed automatic reminders on arrival. Control practices provided usual care. Clustered analyses adjusted for sociodemographic differences among practices were performed using logistic regression.

Results: A total of 12,786 at-risk adults attended 16 intervention practices (received reminders = 4066; 'internal control' receiving usual care = 8720), and 5082 individuals attended eight control practices. Baseline influenza vaccination uptake (2020) was similar in intervention and control practices (∼34%). After the intervention, uptake was similar in all groups (control practices = 29.3%; internal control = 30.0%; intervention = 31.6% (p-value = 0.203). However, SMS 1 h before appointments increased vaccination coverage (39.3%, adjusted OR = 1.65; 95%CI 1.20;2.27; number necessary to treat = 13), especially when combined with other reminder forms. That effect was more evident among adults with chronic respiratory, rheumatologic, or inflammatory bowel disease.

Conclusion: These findings indicate that automated SMS reminders delivered at proximate times to appointments are a low-cost strategy to increase influenza vaccination among adults at higher risk of severe disease attending Australian general practices.

Keywords: Electronic medical records; General practice; Influenza vaccine; Preventive health; Reminder systems; Vaccination coverage.