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A computerized reminder strategy is effective for annual influenza immunization of children with asthma or reactive
M Gaglani1, M Riggs, C Kamenicky
1Scott and White Memorial Hospital and Clinic, Scott, Sherwood and Brindley Foundation, Texas A&M University System Health Science Center College of Medicine, Temple, TX, USA. mgaglani@swmail.sw.org
Insights
Annual influenza immunization is crucial for children with asthma or reactive airway disease (RAD). A computerized reminder system significantly increased vaccination rates from 5.4% to 32.1% in this vulnerable group.
Area of Science:
- Pediatric Pulmonology
- Public Health
- Preventive Medicine
Background:
- Influenza infections often worsen asthma and lead to hospitalizations in children.
- Annual influenza vaccination is recommended for children with asthma or reactive airway disease (RAD), but uptake remains low (<10%).
Purpose of the Study:
- To evaluate the effectiveness of a computerized reminder system in improving influenza immunization rates among children with asthma/RAD.
Main Methods:
- A cohort of 925 children with asthma/RAD received a computerized reminder strategy including a letter and a telephone message.
- The intervention was implemented before and after the 1997-1998 influenza season.
- Immunization rates were compared between the 1996-1997 and 1997-1998 seasons.
Main Results:
- The influenza immunization rate increased significantly from 5.4% to 32.1% across all age groups and insurance statuses.
- Vaccinated children had a significantly lower rate of medically attended acute respiratory illness during and between influenza epidemics compared to unvaccinated children.
Conclusions:
- A combined reminder strategy of letters and autodial telephone messages effectively boosts influenza immunization rates in children with asthma/RAD.
- Children with higher respiratory morbidity were more likely to receive immunizations after the reminder intervention.
Background:
Influenza virus infection frequently triggers asthma exacerbation and hospitalization. Annual influenza immunization is recommended for children with chronic conditions, including those with asthma or reactive airway disease (RAD); however, <10% receive it each year.
Methods:
In September, 1997, we instituted a computerized staged reminder strategy for annual influenza immunization of children with asthma/RAD at the Scott and White Pediatric Clinic in Temple. A reminder letter, followed six weeks later by an autodial recall telephone message, was sent to the parent/guardian of children with asthma/RAD using the Shared Medical Systems to identify children with asthma/RAD and the Integrated Client Encounter System to record immunizations. The effect of this computerized reminder system on the influenza immunization rate of a cohort of 925 Scott and White Pediatric Clinic children with asthma/RAD was examined for the 1996 to 1997 and 1997 to 1998 influenza seasons, before and after intervention.
Results:
A significant increase in influenza immunization rate from 5.4% to 32.1% occurred in all age groups, regardless of the insurance status. The medically attended acute respiratory illness rate per 100 subjects was significantly higher in vaccinated than in unvaccinated children for each of the two influenza epidemics and in the period between the two epidemics.
Conclusion:
A computerized reminder letter followed by an autodial recall telephone message is effective in increasing the influenza immunization rate of children with asthma/RAD. Children with significantly higher respiratory morbidity during and in between two influenza epidemics were more likely to be immunized after receiving written and telephone autodial reminders.
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