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Multimodal approach reduces missed opportunities for influenza vaccination in RA patients

30 Sep 2018

Multimodal approach reduces missed opportunities for influenza vaccination in RA patients

Using a multimodal intervention may improve uptake of influenza vaccination in patients with rheumatoid arthritis (RA), reports a study, adding that some subgroups may need a more potent approach for equivalent efficacy.

Of the 228 patients with RA who participated in the study (904 preintervention visits), 197 returned for at least one postintervention visit (721 postintervention visits). There was a 47-percent preintervention frequency of any missed opportunities for influenza vaccination, and this decreased to 23 percent postintervention (p<0.001).

The relative hazard among those vaccinated for influenza vaccination post vs preintervention period was 1.24 (p=0.038).

Each of the following was independently associated with missed opportunities preintervention: younger age, less frequent office visits, higher erythrocyte sedimentation rate and negative attitudes about vaccines. These factors no longer correlated with missed opportunities postintervention.

However, the intervention appeared to be not as effective in the following: non-Hispanic black patients, non-English speakers, those residing outside of the New York City metropolitan area and those reporting prior adverse reactions to vaccines.

This study recruited RA patients from a single centre. The authors tracked each rheumatology outpatient visit for missed opportunities for influenza vaccination, defined as a visit in which an unvaccinated patient without contraindications remained unvaccinated or lacked documentation of vaccine recommendation in the electronic medical record (EMR).

Subsequently, providers received a multimodal intervention consisting of an education session, EMR alerts and weekly provider-specific e-mail reminders. The authors compared missed opportunities pre- and postintervention, and analysed the determinants of missed opportunities.

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