IMPROVING INFLUENZA VACCINATION COVERAGE AMONG HIGH-RISK PATIENTS - AROLE FOR COMPUTER-SUPPORTED PREVENTION STRATEGY

Background. Worldwide, population-based influenza vaccination strategi es are being developed to trace, immunize and monitor high-risk person s efficiently. Computerized prevention modules may facilitate such a s trategy in general practice. Objectives. We established the applicabil ity of a computerized influenza prevention module and specifically add ressed improvement of immunization coverage in high-risk patients duri ng two consecutive influenza vaccination rounds after introduction of the module. Methods. In this descriptive study, four computerized prac tices of the Utrecht General Practices Network, covering about 36 000 patients, participated. In 1995, all patients with highrisk diseases w ere traced by relevant tags, ICPC- and ATC-codes, using the module. Ac cording to changed Dutch immunization guidelines in 1996, healthy elde rly people over 65 years were also traced. Demographical and medical d ata included age, high-risk disease and vaccine uptake. Results. In Oc tober 1995, 3871 high-risk patients were identified (11% of population ); overall vaccination coverage was 68%. Over one-third of these patie nts had not been indicated before. In between the two vaccination roun ds, 1104 previously unknown patients with high-risk disease <65 years were found by means of the module's on-line status. In October 1996, 6 889 persons, including 2308 healthy elderly, were indicated (19%), and vaccination coverage was 62 %. Of 3477 patients whose high-risk disea ses were documented in both vaccination rounds, an overall improvement of vaccination coverage from 71% in 1995 to 76% in 1996 was observed (P < 0.05). Main improvements were found in elderly patients. Immuniza tion rates were highest in those with more than one risk factor, lung or cardiac disease, and lowest in healthy elderly and patients under 6 5 years with lung, renal or other diseases. Conclusion. Computerized p revention modules and CMRs may facilitate population-based prevention of influenza and the use should be further encouraged.