Cochrane · systematic review · CD005188
Interventions to increase influenza vaccination rates of those 60 years and older in the community
Thomas, RE, Lorenzetti, DL · Cochrane Database of Systematic Reviews · 2018 · Cochrane Library
SoF tableOnly the outcomes this review put in its Summary of Findings table are listed (the Cochrane Handbook caps them at about seven per comparison). Its other analyses are not shown here.
Questions
29
current version
GRADE rated
29
No studies
0
Included studies
NR
No studies 0 · 0%Ungraded 0 · 0%Very low 0 · 0%Low 0 · 0%Moderate 6 · 20.7%High 23 · 79.3%
Ungraded means an effect was reported without a GRADE rating; it is not a gap. No studies means the review found nothing to answer the question. The six categories are a display order, not a score.
Questions and results
Current version onlyIncreasing community demand compared to no intervention or another intervention for increasing influenza vaccination uptake
Population: people aged 60 years and older living in the community
| Outcome | Effect | Evidence | Status / GRADE |
|---|---|---|---|
Client reminder and recall (postcard) compared to no intervention Increasing community demand vs no intervention or another intervention | no estimate extracted | 17 studies · 402367 participants | High |
Client reminder and recall (tailored letter or postcard or phone call) compared to no intervention Increasing community demand vs no intervention or another intervention | no estimate extracted | 16 studies · 195964 participants | High |
Client reminder and recall (letter + leaflet or postcard) compared to letter Increasing community demand vs no intervention or another intervention | OR 1.11 [1.07, 1.15] | 3 studies · 64200 participants | High |
Client reminder and recall (customised letter or phone call) compared to form letter Increasing community demand vs no intervention or another intervention | no estimate extracted | 4 studies · 82465 participants | High |
Client reminder and recall (telephone call from retired teacher plus educational brochure) compared to usual publicity Increasing community demand vs no intervention or another intervention | OR 3.33 [1.79, 6.22] | 1 study · 193 participants | High |
Client reminder and recall (telephone invitation) compared to invitation to patient when "dropped in" to clinic Increasing community demand vs no intervention or another intervention | OR 2.72 [1.55, 4.76] | 1 study · 243 participants | Moderate Downgraded: risk of bias |
Brochure + lottery for free groceries compared to no intervention Increasing community demand vs no intervention or another intervention | OR 1.04 [0.62, 1.76] | 1 study · 291 participants | High |
Questionnaires to clients about attitudes Increasing community demand vs no intervention or another intervention | OR 1.13 [1.03, 1.24] | 1 study · 13809 participants | High |
Client‐based education (health risk appraisal) compared to no intervention Increasing community demand vs no intervention or another intervention | no estimate extracted | 4 studies · 6300 participants | High |
Client‐based education (nurses or pharmacists educated and nurses vaccinated participants) compared to no intervention Increasing community demand vs no intervention or another intervention | OR 3.29 [1.91, 5.66] | 2 studies · 614 participants | High |
Client‐based education (nurses educated and vaccinated participants) compared to nurses educated participants Increasing community demand vs no intervention or another intervention | OR 152.95 [9.39, 2490.67] | 1 study · 485 participants | High |
Face‐to‐face 3‐minute conversation compared to no intervention Increasing community demand vs no intervention or another intervention | OR 1.62 [1.11, 2.35] | 1 study · 529 participants | Moderate Downgraded: risk of bias |
Enhancing vaccination access compared to no intervention or another intervention for increasing influenza vaccination uptake
Population: people aged 60 years and older living in the community
| Outcome | Effect | Evidence | Status / GRADE |
|---|---|---|---|
Group visits of participants to physician and nurse compared to usual care Enhancing vaccination access vs no intervention or another intervention | OR 27.19 [1.6, 463.25] | 1 study · 321 participants | Moderate Downgraded: risk of bias |
Home visit compared to invitation to attend influenza vaccination clinic Enhancing vaccination access vs no intervention or another intervention | OR 1.3 [1.05, 1.61] | 2 studies · 2112 participants | High |
Home visit with encouragement to receive influenza vaccination compared to home visit with safety intervention Enhancing vaccination access vs no intervention or another intervention | OR 0.98 [0.64, 1.5] | 1 study · 350 participants | High |
Home visit by nurse or group sessions with encouragement to receive influenza vaccination plus care plan developed with physician compared to no intervention Enhancing vaccination access vs no intervention or another intervention | no estimate extracted | 2 studies · 2069 participants | High |
Free influenza vaccine compared to invitation to be vaccinated but patient pays Enhancing vaccination access vs no intervention or another intervention | OR 2.36 [1.98, 2.82] | 2 studies · 2251 participants | High |
Free influenza vaccine compared to no intervention Enhancing vaccination access vs no intervention or another intervention | no estimate extracted | 2 studies · 2250 participants | High |
Provider‐ or system‐based interventions compared to no intervention or another intervention for increasing influenza vaccination uptake
Population: people aged 60 years and older living in the community
| Outcome | Effect | Evidence | Status / GRADE |
|---|---|---|---|
Reminder (to physician) compared to no reminder Provider‐ or system‐based interventions vs no intervention or another intervention | no estimate extracted | 4 studies · 202264 participants | High |
Reminder to physician about all participants compared to reminder about half of participants Provider‐ or system‐based interventions vs no intervention or another intervention | OR 2.47 [1.53, 3.99] | 1 study · 316 participants | High |
Reminder (to hospital staff to vaccinate patient) compared to reminder letter to GP on day of discharge Provider‐ or system‐based interventions vs no intervention or another intervention | OR 1.7 [0.51, 5.7] | 1 study · 45 participants | High |
Posters in clinic displaying influenza vaccination rates to encourage doctors to compete plus postcards to participants compared to no intervention Provider‐ or system‐based interventions vs no intervention or another intervention | OR 2.03 [1.86, 2.22] | 1 study · 8376 participants | High |
Posters in clinic displaying influenza vaccination rates to encourage doctors to compete plus postcards to participants compared to posters alone Provider‐ or system‐based interventions vs no intervention or another intervention | OR 1.06 [0.95, 1.19] | 1 study · 5753 participants | High |
Facilitator encouragement of prevention manoeuvres including influenza vaccination compared to no intervention Provider‐ or system‐based interventions vs no intervention or another intervention | no estimate extracted | 3 studies · 2183 participants | Moderate Downgraded: risk of bias |
Educational reminders, academic detailing, and peer comparisons to physicians compared to mailed educational materials Provider‐ or system‐based interventions vs no intervention or another intervention | OR 1.13 [0.8, 1.58] | 1 study · 1400 participants | Moderate Downgraded: risk of bias |
Chart review and feedback to physician plus benchmarking to vaccination rates achieved by top 10% of physicians compared to chart review and feedback Provider‐ or system‐based interventions vs no intervention or another intervention | OR 3.43 [2.37, 4.97] | 1 study · 1360 participants | Moderate Downgraded: risk of bias |
Educational outreach plus feedback to practice teams versus written feedback to practice teams Provider‐ or system‐based interventions vs no intervention or another intervention | OR 0.77 [0.72, 0.81] | 1 study · 27580 participants | High |
Payment to physicians versus no payment Provider‐ or system‐based interventions vs no intervention or another intervention | OR 2.22 [1.77, 2.77] | 2 studies · 2815 participants | High |
Intervention to increase staff influenza vaccination rate versus no intervention Provider‐ or system‐based interventions vs no intervention or another intervention | OR 1.04 [0.97, 1.12] | 1 study · 26432 participants | High |
Summary of effects of interventions to increase influenza vaccination uptake
Population: all ≥ 60, any country
| Outcome | Effect | Evidence | Status / GRADE |
|---|---|---|---|
No intervention | no estimate extracted | 10 studies · 30377 participants | Low Downgraded: risk of bias, imprecision, inconsistency, indirectness |
"usual care" ‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐ No intervention ‐‐‐‐‐‐‐‐‐‐‐‐‐ Safety intervention | no estimate extracted | 2 studies · 710 participants | Moderate Downgraded: risk of bias, imprecision, inconsistency, indirectness |
Patient paid | no estimate extracted | 2 studies · 1125 participants | Very low Downgraded: risk of bias, imprecision, inconsistency, indirectness |
Chart review and feedback | no estimate extracted | 3 studies · 15017 participants | Very low Downgraded: risk of bias, imprecision, inconsistency, indirectness |
Payment per vaccination | no estimate extracted | 2 studies · 1559 participants | Low Downgraded: risk of bias, imprecision, inconsistency, indirectness |
Summary of effects of interventions to increase influenza vaccination rates
Population: all ≥ 60, any country
| Outcome | Effect | Evidence | Status / GRADE |
|---|---|---|---|
No intervention | no estimate extracted | 10 studies · 30377 participants | Low Downgraded: risk of bias, imprecision, inconsistency, indirectness |
"usual care" ‐‐‐‐‐‐‐‐‐‐‐‐‐‐‐ No intervention ‐‐‐‐‐‐‐‐‐‐‐‐‐ Safety intervention | no estimate extracted | 2 studies · 710 participants | Moderate Downgraded: risk of bias, imprecision, inconsistency, indirectness |
Patient paid | no estimate extracted | 2 studies · 1125 participants | Very low Downgraded: risk of bias, imprecision, inconsistency, indirectness |
Chart review and feedback | no estimate extracted | 3 studies · 15017 participants | Very low Downgraded: risk of bias, imprecision, inconsistency, indirectness |
Payment per vaccination | no estimate extracted | 2 studies · 1559 participants | Low Downgraded: risk of bias, imprecision, inconsistency, indirectness |