OpenLB
Open Library of Bioscience
Advanced Search
American journal of public health
12, 2019;109 (12): 1776-1783.

Increasing Influenza and Pneumococcal Vaccination Uptake in Seniors Using Point-of-Care Informational Interventions in Primary Care in Singapore: A Pragmatic, Cluster-Randomized Crossover Trial.

Hanley J Ho, Yi-Roe Tan, Alex R Cook, Gerald Koh, Tat Yean Tham, Eve Anwar, Grace Shu Hui Chiang, May O Lwin, Mark I Chen
Author Information
  1. Hanley J Ho: Hanley J. Ho is with the Department of Clinical Epidemiology, Office of Clinical Epidemiology, Analytics, and Knowledge, Tan Tock Seng Hospital, Singapore. Yi-Roe Tan and Mark I. Chen are with the National Centre for Infectious Diseases, Singapore. Alex R. Cook and Gerald Koh are with the Saw Swee Hock School of Public Health, National University of Singapore, Singapore. Tat Yean Tham is with Frontier Healthcare Group, Singapore. Eve Anwar is with OneCare Medical Group Pte Ltd, Singapore. Grace Shu Hui Chiang is with the Department of Medicine, St Luke's Hospital, Singapore. May O. Lwin is with the Wee Kim Wee School of Communication and Information, Nanyang Technological University, Singapore.
  2. Yi-Roe Tan: Hanley J. Ho is with the Department of Clinical Epidemiology, Office of Clinical Epidemiology, Analytics, and Knowledge, Tan Tock Seng Hospital, Singapore. Yi-Roe Tan and Mark I. Chen are with the National Centre for Infectious Diseases, Singapore. Alex R. Cook and Gerald Koh are with the Saw Swee Hock School of Public Health, National University of Singapore, Singapore. Tat Yean Tham is with Frontier Healthcare Group, Singapore. Eve Anwar is with OneCare Medical Group Pte Ltd, Singapore. Grace Shu Hui Chiang is with the Department of Medicine, St Luke's Hospital, Singapore. May O. Lwin is with the Wee Kim Wee School of Communication and Information, Nanyang Technological University, Singapore.
  3. Alex R Cook: Hanley J. Ho is with the Department of Clinical Epidemiology, Office of Clinical Epidemiology, Analytics, and Knowledge, Tan Tock Seng Hospital, Singapore. Yi-Roe Tan and Mark I. Chen are with the National Centre for Infectious Diseases, Singapore. Alex R. Cook and Gerald Koh are with the Saw Swee Hock School of Public Health, National University of Singapore, Singapore. Tat Yean Tham is with Frontier Healthcare Group, Singapore. Eve Anwar is with OneCare Medical Group Pte Ltd, Singapore. Grace Shu Hui Chiang is with the Department of Medicine, St Luke's Hospital, Singapore. May O. Lwin is with the Wee Kim Wee School of Communication and Information, Nanyang Technological University, Singapore.
  4. Gerald Koh: Hanley J. Ho is with the Department of Clinical Epidemiology, Office of Clinical Epidemiology, Analytics, and Knowledge, Tan Tock Seng Hospital, Singapore. Yi-Roe Tan and Mark I. Chen are with the National Centre for Infectious Diseases, Singapore. Alex R. Cook and Gerald Koh are with the Saw Swee Hock School of Public Health, National University of Singapore, Singapore. Tat Yean Tham is with Frontier Healthcare Group, Singapore. Eve Anwar is with OneCare Medical Group Pte Ltd, Singapore. Grace Shu Hui Chiang is with the Department of Medicine, St Luke's Hospital, Singapore. May O. Lwin is with the Wee Kim Wee School of Communication and Information, Nanyang Technological University, Singapore.
  5. Tat Yean Tham: Hanley J. Ho is with the Department of Clinical Epidemiology, Office of Clinical Epidemiology, Analytics, and Knowledge, Tan Tock Seng Hospital, Singapore. Yi-Roe Tan and Mark I. Chen are with the National Centre for Infectious Diseases, Singapore. Alex R. Cook and Gerald Koh are with the Saw Swee Hock School of Public Health, National University of Singapore, Singapore. Tat Yean Tham is with Frontier Healthcare Group, Singapore. Eve Anwar is with OneCare Medical Group Pte Ltd, Singapore. Grace Shu Hui Chiang is with the Department of Medicine, St Luke's Hospital, Singapore. May O. Lwin is with the Wee Kim Wee School of Communication and Information, Nanyang Technological University, Singapore.
  6. Eve Anwar: Hanley J. Ho is with the Department of Clinical Epidemiology, Office of Clinical Epidemiology, Analytics, and Knowledge, Tan Tock Seng Hospital, Singapore. Yi-Roe Tan and Mark I. Chen are with the National Centre for Infectious Diseases, Singapore. Alex R. Cook and Gerald Koh are with the Saw Swee Hock School of Public Health, National University of Singapore, Singapore. Tat Yean Tham is with Frontier Healthcare Group, Singapore. Eve Anwar is with OneCare Medical Group Pte Ltd, Singapore. Grace Shu Hui Chiang is with the Department of Medicine, St Luke's Hospital, Singapore. May O. Lwin is with the Wee Kim Wee School of Communication and Information, Nanyang Technological University, Singapore.
  7. Grace Shu Hui Chiang: Hanley J. Ho is with the Department of Clinical Epidemiology, Office of Clinical Epidemiology, Analytics, and Knowledge, Tan Tock Seng Hospital, Singapore. Yi-Roe Tan and Mark I. Chen are with the National Centre for Infectious Diseases, Singapore. Alex R. Cook and Gerald Koh are with the Saw Swee Hock School of Public Health, National University of Singapore, Singapore. Tat Yean Tham is with Frontier Healthcare Group, Singapore. Eve Anwar is with OneCare Medical Group Pte Ltd, Singapore. Grace Shu Hui Chiang is with the Department of Medicine, St Luke's Hospital, Singapore. May O. Lwin is with the Wee Kim Wee School of Communication and Information, Nanyang Technological University, Singapore.
  8. May O Lwin: Hanley J. Ho is with the Department of Clinical Epidemiology, Office of Clinical Epidemiology, Analytics, and Knowledge, Tan Tock Seng Hospital, Singapore. Yi-Roe Tan and Mark I. Chen are with the National Centre for Infectious Diseases, Singapore. Alex R. Cook and Gerald Koh are with the Saw Swee Hock School of Public Health, National University of Singapore, Singapore. Tat Yean Tham is with Frontier Healthcare Group, Singapore. Eve Anwar is with OneCare Medical Group Pte Ltd, Singapore. Grace Shu Hui Chiang is with the Department of Medicine, St Luke's Hospital, Singapore. May O. Lwin is with the Wee Kim Wee School of Communication and Information, Nanyang Technological University, Singapore.
  9. Mark I Chen: Hanley J. Ho is with the Department of Clinical Epidemiology, Office of Clinical Epidemiology, Analytics, and Knowledge, Tan Tock Seng Hospital, Singapore. Yi-Roe Tan and Mark I. Chen are with the National Centre for Infectious Diseases, Singapore. Alex R. Cook and Gerald Koh are with the Saw Swee Hock School of Public Health, National University of Singapore, Singapore. Tat Yean Tham is with Frontier Healthcare Group, Singapore. Eve Anwar is with OneCare Medical Group Pte Ltd, Singapore. Grace Shu Hui Chiang is with the Department of Medicine, St Luke's Hospital, Singapore. May O. Lwin is with the Wee Kim Wee School of Communication and Information, Nanyang Technological University, Singapore.
PMID: 31622142 DOI: 10.2105/AJPH.2019.305328

Abstract

To evaluate the effectiveness of point-of-care informational interventions in general practitioner clinics to improve influenza and pneumococcal vaccination uptake among elderly patients. We conducted a pragmatic, cluster-randomized crossover trial in 22 private general practitioner clinics in Singapore, from November 2017 to July 2018. We included all patients aged 65 years or older. Clinics were assigned to a 3-month intervention (flyers and posters encouraging vaccination) plus 1-month washout period, and a 4-month control period (usual care). Primary outcomes were differences in vaccination uptake rates between periods. Secondary outcomes were identification of other factors associated with vaccination uptake. A total of 4378 and 4459 patients were included in the intervention and control periods, respectively. Both influenza (5.9% vs 4.8%;  = .047) and pneumococcal (5.7% vs 3.7%;  = .001) vaccination uptake rates were higher during the intervention period compared with the control period. On multilevel logistic regression analysis, follow-up for hypertension, diabetes mellitus, hyperlipidemia, or any combination of the 3 was associated with uptake of both vaccines. Point-of-care informational interventions likely contributed to increased influenza and pneumococcal vaccination uptake. Patients on follow-up for hypertension, diabetes mellitus, hyperlipidemia, or any combination of the 3 were more likely to receive influenza and pneumococcal vaccination and should be actively engaged by physicians. ClinicalTrials.gov Identifier: NCT03445117.

Associated Data

ClinicalTrials.gov | NCT03445117

References

  1. J Infect Dis. 2018 Feb 14;217(5):731-741 [PMID: 29220496]
  2. Vaccine. 2017 Nov 7;35(47):6367-6374 [PMID: 29031694]
  3. Emerg Infect Dis. 2006 Jan;12(1):114-21 [PMID: 16494727]
  4. Health Technol Assess. 2014 Jul;18(43):1-146 [PMID: 25011568]
  5. Epidemiol Infect. 2017 Mar;145(4):775-786 [PMID: 27927253]
  6. Br J Gen Pract. 2007 May;57(538):352-8 [PMID: 17504584]
  7. BMC Public Health. 2013 Apr 25;13:388 [PMID: 23617788]
  8. Cochrane Database Syst Rev. 2018 May 30;5:CD005188 [PMID: 29845606]
  9. Vaccine. 2017 Jan 5;35(2):212-221 [PMID: 27939013]
  10. BMJ Open. 2016 Dec 28;6(12):e012618 [PMID: 28031209]
  11. Singapore Med J. 2007 Sep;48(9):824-9 [PMID: 17728963]
  12. Clin Exp Vaccine Res. 2017 Jan;6(1):38-44 [PMID: 28168172]
  13. Ann Fam Med. 2012 Nov-Dec;10(6):538-46 [PMID: 23149531]
  14. PLoS One. 2017 Jan 6;12(1):e0169368 [PMID: 28061505]
  15. Wkly Epidemiol Rec. 2012 Nov 23;87(47):461-76 [PMID: 23210147]
  16. Ann Med. 2018 May;50(3):181-192 [PMID: 29338438]
  17. Int J Environ Res Public Health. 2017 Jun 20;14(6): [PMID: 28632192]
  18. Cochrane Database Syst Rev. 2006 Jul 19;(3):CD004876 [PMID: 16856068]
  19. N Engl J Med. 2015 Mar 19;372(12):1114-25 [PMID: 25785969]
  20. MMWR Morb Mortal Wkly Rep. 2014 Sep 19;63(37):822-5 [PMID: 25233284]
  21. Stat Med. 2007 Jan 30;26(2):274-89 [PMID: 16538700]
  22. PLoS One. 2009 Dec 01;4(12):e8096 [PMID: 19956611]
  23. Clin Infect Dis. 2017 Nov 13;65(11):1905-1913 [PMID: 29028950]
  24. BMC Public Health. 2015 Jul 07;15:618 [PMID: 26148480]
  25. Clin Infect Dis. 2019 Jun 18;69(1):121-129 [PMID: 30277500]
  26. PLoS One. 2018 Mar 22;13(3):e0193029 [PMID: 29565990]
  27. Hum Vaccin Immunother. 2018 Feb 1;14(2):430-441 [PMID: 29194019]
  28. Stat Med. 2017 Jan 30;36(2):318-333 [PMID: 27680896]
  29. Hum Vaccin Immunother. 2016 Jul 2;12(7):1891-9 [PMID: 27064311]
  30. BMJ Open. 2016 Feb 19;6(2):e010069 [PMID: 26895984]
  31. Scand J Rheumatol. 2017 Nov;46(6):446-453 [PMID: 28145151]
  32. Scand J Public Health. 2018 Mar;46(2):175-181 [PMID: 28701087]
  33. Asia Pac Fam Med. 2014 Jul 19;13(1):8 [PMID: 25120380]

MeSH Term

Aged
Aged, 80 and over
Cross-Over Studies
Diabetes Mellitus
Female
Health Promotion
Humans
Hyperlipidemias
Hypertension
Influenza Vaccines
Influenza, Human
Logistic Models
Male
Pneumococcal Infections
Pneumococcal Vaccines
Point-of-Care Systems
Singapore
Socioeconomic Factors

Chemicals

Influenza Vaccines
Pneumococcal Vaccines
Journal Article Randomized Controlled Trial Research Support, Non-U.S. Gov't
Article has an altmetric score of 5

Word Cloud

Created with Highcharts 10.0.0vaccinationuptakeinfluenzapneumococcalperiodpatientsinterventioncontrol3informationalinterventionsgeneralpractitionerclinicsincludedPrimaryoutcomesratesperiodsassociated5vs = 7%follow-uphypertensiondiabetesmellitushyperlipidemiacombinationlikelyevaluateeffectivenesspoint-of-careimproveamongelderlyconductedpragmaticcluster-randomizedcrossovertrial22privateSingaporeNovember2017July2018aged65yearsolderClinicsassigned3-monthflyerspostersencouragingplus1-monthwashout4-monthusualcaredifferencesSecondaryidentificationfactorstotal43784459respectively9%48%047001highercomparedmultilevellogisticregressionanalysisvaccinesPoint-of-carecontributedincreasedPatientsreceiveactivelyengagedphysiciansClinicalTrialsgovIdentifier:NCT03445117IncreasingInfluenzaPneumococcalVaccinationUptakeSeniorsUsingPoint-of-CareInformationalInterventionsCareSingapore:PragmaticCluster-RandomizedCrossoverTrial

Similar Articles

Cited By