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Patient reminders ‘effective’ at boosting vaccination uptake

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Reminding patients when their vaccinations are due or overdue increases the number of people being immunised, according to a Cochrane review led by nurse researchers.

A range of methods to remind patients had been found to be effective, they said, but reminding people over the telephone seemed to achieve the best results.

“We have the technology to incorporate patient reminders and recall into routine primary care”

Julie Jacobson Vann

But they also highlighted that recent developments in communications and digital technology meant reminders could be delivered in a range of ways and routinely incorporated into primary care.

The authors of the review noted that, while immunisation rates against infectious diseases were improving, “under-vaccination” remains a problem that results in preventable deaths and illnesses.

For example, they noted that, in Europe, 11,316 cases of measles were reported during 2012 and an estimated four to 50 million symptomatic cases of influenza occur each year.

The researchers noted that reminders could address common reasons that jabs may be missed, such as forgetting or missing appointments, not knowing schedules or concerns about vaccinations.

They also highlighted that reminders could be sent to patients, parents or guardians, or even whole populations when vaccines were due – either because of age or other risk factors.

In addition, they pointed out that reminders and recalls – sent when jabs were overdue – could be sent by many methods, including letter, postcard, telephone call, computerised call, or text message.

However, for reminders to be successful, the researchers warned that primary care vaccination and contact records needed to be up-to-date, and vaccination services themselves must be accessible.

The team of researchers have updated a Cochrane systematic review summarising the results of 75 studies from 10 countries, including 55 studies involving 138,625 children, adolescents and adults.

“All types of patient reminder and recall are likely to be effective”

Julie Jacobson Vann

Some of the studies covered reminders for routine immunisations in children such as MMR and polio, while others looked at adolescent and adult vaccinations such as tetanus, hepatitis B or flu.

The studies looked at reminders given by various formats and combinations, comparing them with no reminders, media campaigns or local general practice awareness drives.

The Cochrane researchers found that reminder and recall systems increased the number of children and adults receiving any kind of immunisation.

Based on the results from combining studies in adults and children, about 8% more people received a vaccination following a reminder compared with no reminder, they said.

Similar results were found in children and adults when they were analysed separately, they added in their report, published today as part of the Cochrane Database of Systematic Reviews.

They noted that there was “high quality evidence” that postcards, text messages and computerised telephone calls were all effective methods for delivering reminders.

Lead author Dr Julie Jacobson Vann, an assistant professor from the school of nursing at the University of North Carolina at Chapel Hill, said: “The evidence shows that reminding people to have vaccinations increases the number of people who receive vaccinations.

“All types of patient reminder and recall are likely to be effective, and reminding people over the telephone was most effective,” she said.

University of North Carolina at Chapel Hill

Patient reminders for vaccination effective at boosting uptake

Julie Jacobson Vann

“Even a small effect of patient reminders and recalls, when scaled to a whole population, could have a large beneficial effect on public health,” stated Dr Jacobson Vann.

“We have the technology to incorporate patient reminders and recall into routine primary care,” she highlighted.

However, she noted that reminder and recall systems needed to be “tailored” to each setting to maximise effectiveness, for example, telephone reminders by staff were effective but costly.

She added: “As technologies develop we need to consider how they can enhance reminder and recall interventions. For example, we need to learn more about the characteristics of the most effective centralised and text message interventions.”

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