Immunization Programs Clinical Trial
Official title:
Increasing the Uptake of Influenza and Pneumococcal Vaccines Among High-Risk Adult Patients Through General Practitioner Clinics
Pneumonia and influenza are among the top causes of hospitalisation and death in the elderly. While vaccinations are recommended against these diseases, a large proportion of elderly in the community remain unvaccinated, with approximately only 10% vaccinated for either disease. In this study, the investigators aim to implement an intervention package within GP clinics to increase influenza and pneumococcal vaccination rates, especially among elderly patients with chronic diseases.
Influenza and pneumococcal disease contribute considerably to hospitalisation and mortality
in the elderly. While recommended vaccines can reduce disease burden, vaccine uptake remains
very low in Singapore, with approximately only 10% of elderly appropriately vaccinated for
either disease. Improving vaccine uptake rates could be effected through private sector
primary care clinics, which are highly accessible in Singapore. An intervention bundle we
piloted in one clinic comprised physician reminders and patient-targeted posters and
brochures. Influenza and pneumococcal vaccine rates both increased by >30% over the baseline,
although half of eligible patients remained unvaccinated. There is thus scope to devise a
more effective intervention bundle and demonstrate its efficacy through a more robust and
generalisable study design.
This study aims to evaluate the efficacy of an intervention bundle deployed in general
practice clinics to promote influenza and pneumococcal vaccine uptake among elderly patients.
The intervention bundle components include educational materials such as posters and flyers,
which also serve as reminder slips for attending physicians. The intervention will be
implemented in a two-arm cluster randomised crossover trial in up to 30 primary care clinics.
Control arm clinics will receive no interventions. Clinics will be randomised into either of
the two arms for a period of 3 months, followed by a washout of 1 month before a crossover is
performed. The investigators will subsequently compare vaccination rates during intervention
and control periods to provide evidence for effectiveness of the intervention.
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