J Clin Outcomes Manage
Improving influenza vaccine coverage among asthmatics: a practice-based research network study
Walter EB, Hellkamp AS, Goldberg KC, Montgomery D, Patterson B, Dolor RJ
Abstract Objective: To evaluate an educational postcard reminder and practice improvement interventions intended to improve influenza vaccination rates among asthmatic patients. Design: Pre–post study. Patients and setting: Patients with asthma followed at 15 primary care practices located in central North Carolina. Measurements: Vaccine coverage was assessed utilizing 3 sources of immunization information: an administrative database containing immunization order and billing data, a mailed postcard survey, and an in-office handheld computer survey. Changes in vaccine coverage were compared between 8 intervention practices and 7 nonintervention practices. Results: In 2002–2003, the influenza vaccine coverage rates as assessed by the 3 respective methods were 23%, 78%, and 45%, and in 2003–2004 they were 26%, 77%, and 58%. In both years, vaccine coverage did not improve with the addition of the educational message to the postcard reminder. The mean change in vaccine coverage in the practice intervention sites was +4.5%, compared with +4.0% in control practices (p = 0.55). Vaccine coverage was lower among nonwhites (p = 0.001), the uninsured (p = 0.001), and young adults (p = 0.001). Of those not receiving influenza vaccine, nearly half had concerns that the vaccine would cause the flu. Conclusions: Influenza vaccine coverage among asthmatics remains suboptimal. Neither the educational reminder nor the practice improvement strategy employed significantly influenced vaccine coverage rates in this study. Alternative strategies towards increasing influenza vaccine coverage among asthmatics should address continued misconceptions about the influenza vaccine.
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