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30.01.2018 | Original Research

Improving Rates of Outpatient Influenza Vaccination Through EHR Portal Messages and Interactive Automated Calls: A Randomized Controlled Trial

verfasst von: Sarah L. Cutrona, MD, MPH, Jessica G. Golden, MPH, Sarah L. Goff, MD, Jessica Ogarek, MS, Bruce Barton, PhD, Lloyd Fisher, MD, Peggy Preusse, RN, Devi Sundaresan, MS, Lawrence Garber, MD, Kathleen M. Mazor, EdD

Erschienen in: Journal of General Internal Medicine | Ausgabe 5/2018

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Abstract

Background

Patient reminders for influenza vaccination, delivered via electronic health record (EHR) patient portal messages and interactive voice response (IVR) calls, offer an innovative approach to improving patient care.

Objective

To test the effectiveness of portal and IVR outreach in improving rates of influenza vaccination.

Design

Randomized controlled trial of EHR portal messages and IVR calls promoting influenza vaccination.

Participants

Adults with no documented influenza vaccination 2 months after the start of influenza season (2014–2015).

Intervention

Using a factorial design, we assigned 20,000 patients who were active portal users to one of four study arms: (a) receipt of a portal message promoting influenza vaccines, (b) receipt of IVR call with similar content, (c) both a and b, or (d) neither (usual care). We randomized 10,000 non-portal users to receipt of IVR call or usual care. In all intervention arms, information on pneumococcal vaccination was included if the targeted patient was overdue for pneumococcal vaccine.

Main Measures

EHR-documented influenza vaccination during the 2014–2015 influenza season, measured April 2015.

Key Results

Among portal users, 14.0% (702) of those receiving both portal messages and calls, 13.4% (669) of message recipients, 12.8% (642) of call recipients, and 11.6% (582) of those with usual care received vaccines. On multivariable analysis of portal users, those receiving portal messages alone (OR 1.20, 95% CI 1.06–1.35) or IVR calls alone (OR 1.15 95% CI 1.02–1.30) were more likely than usual care recipients to be vaccinated. Those receiving both messages and calls were also more likely than the usual care group to be vaccinated (ad hoc analysis, using a Bonferroni correction: OR 1.29, 97.5% CI 1.13, 1.48). Among non-portal users, 8.5% of call recipients and 8.6% of usual care recipients received influenza vaccines (p = NS). Pneumococcal vaccination rates showed no significant improvement.

Conclusions

Our outreach achieved a small but significant improvement in influenza vaccination rates.

Registration: ClinicalTrials.gov Identifier NCT02266277 (https://clinicaltrials.gov/ct2/show/NCT02266277).

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Molinari NA, Ortega-Sanchez IR, Messonnier ML, Thompson WW, Wortley PM, Weintraub E, et al. The annual impact of seasonal influenza in the US: measuring disease burden and costs. Vaccine. 2007;25(27):5086-96. https://doi.org/10.1016/j.vaccine.2007.03.046.CrossRefPubMed

NIH Fact Sheets - Influenza. In: Diseases NIH-NIAID, editor. Research Portfolio Online Reporting Tools (RePORT)2011. Accessed on Jan 9, 2018 at https://report.nih.gov/NIHfactsheets/ViewFactSheet.aspx?csid=133.

National Center for Health Statistics (US. "Health, United States, 2015: with special feature on racial and ethnic health disparities." (2016 May). Report No.: 2016-1232.

Kochanek KD, Murphy SL, Xu J. Deaths: Final Data for 2011. National vital statistics reports : from the Centers for Disease Control and Prevention, National Center for Health Statistics, National Vital Statistics System. 2015;63(3):1-120.

Kochanek KD, Xu J, Murphy SL, Minino AM, Kung HC. Deaths: final data for 2009. National vital statistics reports : from the Centers for Disease Control and Prevention, National Center for Health Statistics, National Vital Statistics System. 2011;60(3):1-116.

Murphy SL, Kochanek KD, Xu J, Heron M. Deaths: Final Data for 2012. National vital statistics reports : from the Centers for Disease Control and Prevention, National Center for Health Statistics, National Vital Statistics System. 2015;63(9):1-117.

Murphy SL, Xu J, Kochanek KD. Deaths: final data for 2010. National vital statistics reports : from the Centers for Disease Control and Prevention, National Center for Health Statistics, National Vital Statistics System. 2013;61(4):1-117.

Xu J, Murphy SL, Kochanek KD, Bastian BA. Deaths: Final Data for 2013. National vital statistics reports : from the Centers for Disease Control and Prevention, National Center for Health Statistics, National Vital Statistics System. 2016;64(2):1-119.

Reed C, Kim IK, Singleton JA, Chaves SS, Flannery B, Finelli L, et al. Estimated influenza illnesses and hospitalizations averted by vaccination--United States, 2013-14 influenza season. MMWR. Morbidity and mortality weekly report. 2014;63(49):1151–54.

10.

A pathway to leadership for adult immunization: recommendations of the National Vaccine Advisory Committee: approved by the National Vaccine Advisory Committee on June 14, 2011. Public health reports (Washington, DC : 1974). 2012 Jan-Feb;127 Suppl 1:1–42.

11.

Appel A. Improving adult immunization rates: overcoming barriers. American family physician. 2011;84(9):977-8.PubMed

12.

Bean-Mayberry B, Yano EM, Mor MK, Bayliss NK, Xu X, Fine MJ. Does sex influence immunization status for influenza and pneumonia in older veterans? Journal of the American Geriatrics Society. 2009;57(8):1427-32. https://doi.org/10.1111/j.1532-5415.2009.02316.x.CrossRefPubMedPubMedCentral

13.

Nichol KL, Lind A, Margolis KL, Murdoch M, McFadden R, Hauge M, et al. The effectiveness of vaccination against influenza in healthy, working adults. The New England journal of medicine. 1995;333(14):889-93. doi: https://doi.org/10.1056/nejm199510053331401.CrossRefPubMed

14.

Vaughn JA, Miller RA. Update on immunizations in adults. American family physician. 2011;84(9):1015-20.PubMed

15.

National Center for Health Statistics (US. 2015). Health, United States, 2014: with special feature on adults aged 55–64. Accessed on Jan 9, 2018 at https://www.ncbi.nlm.nih.gov/pubmed/26086064.

16.

Moniz MH, Hasley S, Meyn LA, Beigi RH. Improving influenza vaccination rates in pregnancy through text messaging: a randomized controlled trial. Obstetrics and gynecology. 2013;121(4):734-40. https://doi.org/10.1097/AOG.0b013e31828642b1.CrossRefPubMed

17.

Odone A, Ferrari A, Spagnoli F, Visciarelli S, Shefer A, Pasquarella C, et al. Effectiveness of interventions that apply new media to improve vaccine uptake and vaccine coverage. Human vaccines & immunotherapeutics. 2015;11(1):72-82. https://doi.org/10.4161/hv.34313.CrossRef

18.

Herrett E, Williamson E, van Staa T, Ranopa M, Free C, Chadborn T, et al. Text messaging reminders for influenza vaccine in primary care: a cluster randomised controlled trial (TXT4FLUJAB). BMJ open. 2016;6(2):e010069. https://doi.org/10.1136/bmjopen-2015-010069.CrossRefPubMedPubMedCentral

19.

Stockwell MS, Kharbanda EO, Martinez RA, Vargas CY, Vawdrey DK, Camargo S. Effect of a text messaging intervention on influenza vaccination in an urban, low-income pediatric and adolescent population: a randomized controlled trial. Jama. 2012;307(16):1702-8. https://doi.org/10.1001/jama.2012.502.CrossRefPubMed

20.

Jordan ET, Bushar JA, Kendrick JS, Johnson P, Wang J. Encouraging Influenza Vaccination Among Text4baby Pregnant Women and Mothers. American journal of preventive medicine. 2015;49(4):563-72. https://doi.org/10.1016/j.amepre.2015.04.029.CrossRefPubMed

21.

Stockwell MS, Westhoff C, Kharbanda EO, Vargas CY, Camargo S, Vawdrey DK, et al. Influenza vaccine text message reminders for urban, low-income pregnant women: a randomized controlled trial. American journal of public health. 2014;104 Suppl 1:e7-12. https://doi.org/10.2105/ajph.2013.301620.CrossRefPubMedPubMedCentral

22.

Ghadieh AS, Hamadeh GN, Mahmassani DM, Lakkis NA. The effect of various types of patients' reminders on the uptake of pneumococcal vaccine in adults: A randomized controlled trial. Vaccine. 2015;33(43):5868-72. https://doi.org/10.1016/j.vaccine.2015.07.050.CrossRefPubMed

23.

Thomas RE, Russell ML, Lorenzetti DL. Systematic review of interventions to increase influenza vaccination rates of those 60 years and older. Vaccine. 2010;28(7):1684-701. https://doi.org/10.1016/j.vaccine.2009.11.067.CrossRefPubMed

24.

Jacobson Vann JC, Szilagyi P. Patient reminder and patient recall systems to improve immunization rates. The Cochrane database of systematic reviews. 2005 Jul 20(3):Cd003941. https://doi.org/10.1002/14651858.CD003941.pub2.

25.

Lau AY, Sintchenko V, Crimmins J, Magrabi F, Gallego B, Coiera E. Impact of a web-based personally controlled health management system on influenza vaccination and health services utilization rates: a randomized controlled trial. Journal of the American Medical Informatics Association : JAMIA. 2012;19(5):719-27. https://doi.org/10.1136/amiajnl-2011-000433.CrossRefPubMedPubMedCentral

26.

Krist AH, Woolf SH, Rothemich SF, Johnson RE, Peele JE, Cunningham TD, et al. Interactive preventive health record to enhance delivery of recommended care: a randomized trial. Annals of family medicine. 2012;10(4):312-9. https://doi.org/10.1370/afm.1383.CrossRefPubMedPubMedCentral

27.

Wright A, Poon EG, Wald J, Feblowitz J, Pang JE, Schnipper JL, et al. Randomized controlled trial of health maintenance reminders provided directly to patients through an electronic PHR. Journal of general internal medicine. 2012;27(1):85-92. https://doi.org/10.1007/s11606-011-1859-6.CrossRefPubMed

28.

HealthIT.gov. What is a patient portal? Available at: https://www.healthit.gov/providers-professionals/faqs/what-patient-portal. Accessed November 20, 2017.

29.

Kruse CS, Argueta DA, Lopez L, Nair A. Patient and provider attitudes toward the use of patient portals for the management of chronic disease: a systematic review. Journal of medical Internet research. 2015;17(2):e40. https://doi.org/10.2196/jmir.3703.CrossRefPubMedPubMedCentral

30.

Kruse CS, Bolton K, Freriks G. The effect of patient portals on quality outcomes and its implications to meaningful use: a systematic review. Journal of medical Internet research. 2015;17(2):e44. https://doi.org/10.2196/jmir.3171.CrossRefPubMedPubMedCentral

31.

Cutrona SL, Sreedhara M, Goff SL, Fisher LD, Preusse P, Jackson M, et al. Improving Rates of Influenza Vaccination Through Electronic Health Record Portal Messages, Interactive Voice Recognition Calls and Patient-Enabled Electronic Health Record Updates: Protocol for a Randomized Controlled Trial. JMIR research protocols. 2016;5(2):e56. https://doi.org/10.2196/resprot.5478.CrossRefPubMedPubMedCentral

32.

Minor DS, Eubanks JT, Butler KR, Jr., Wofford MR, Penman AD, Replogle WH. Improving influenza vaccination rates by targeting individuals not seeking early seasonal vaccination. The American journal of medicine. 2010;123(11):1031-5. https://doi.org/10.1016/j.amjmed.2010.06.017.CrossRefPubMed

33.

Fischer GS, Hess R, Landeen BM, Weimer M, Zieth CR, Dong X, et al. Electronic reminders to patients within an interactive patient health record. Telemedicine journal and e-health : the official journal of the American Telemedicine Association. 2013;19(6):497-500. https://doi.org/10.1089/tmj.2012.0116.CrossRef

Titel: Improving Rates of Outpatient Influenza Vaccination Through EHR Portal Messages and Interactive Automated Calls: A Randomized Controlled Trial
verfasst von: Sarah L. Cutrona, MD, MPH
Jessica G. Golden, MPH
Sarah L. Goff, MD
Jessica Ogarek, MS
Bruce Barton, PhD
Lloyd Fisher, MD
Peggy Preusse, RN
Devi Sundaresan, MS
Lawrence Garber, MD
Kathleen M. Mazor, EdD
Publikationsdatum: 30.01.2018
Verlag: Springer US
Erschienen in: Journal of General Internal Medicine / Ausgabe 5/2018
Print ISSN: 0884-8734
Elektronische ISSN: 1525-1497
DOI: https://doi.org/10.1007/s11606-017-4266-9

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Abstract

Background

Objective

Design

Participants

Intervention

Main Measures

Key Results

Conclusions

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