IMPROVING INFLUENZA VACCINE COVERAGE IN AT-RISK GROUPS - GOOD INTENTIONS ARE NOT ENOUGH

Objectives: To raise awareness of the need for annual influenza vaccin ation in the elderly (those 65 years of age and older), and of the eff icacy of organisational practice strategies (specifically at-risk regi sters and reminder systems) to improve influenza vaccine coverage. Dat a sources: Extensive search of the existing literature using MEDLINE a nd manual searching techniques. Recent key review articles on organisa tional strategies were also studied. Study selection: Primary source a rticles were included if they evaluated the efficacy of vaccination an d the various strategies used to improve coverage. More attention was paid to randomised controlled trials, although other study designs wer e considered. A formal algorithm for estimating the effect of organisa tional strategies was not used; rather, appropriate studies which high lighted advantages and disadvantages were selected. Results: Current l evels of vaccination for influenza are low. Negative patient attitudes and lack of an organised and systematic approach are the major barrie rs to improving vaccination rates. Vaccination coverage can be improve d by 10%-30% by use of at-risk registers and reminder systems. Conclus ions: Further research is required to determine the impact of both pat ient attitudes and reminder systems on influenza vaccination rates. A randomised controlled trial is currently underway to look at both thes e issues. Provider and patient reminder systems should be incorporated into general practice to improve the influenza vaccination rate.