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Quality improvement programs for adult immunization: a scoping literature review
Matthew Z Dudley1, Amimah F Asif2, Ebony S Thomas2
1Department of International Health, Johns Hopkins University Bloomberg School of Public Health, Baltimore, MD, USA; Institute for Vaccine Safety, Johns Hopkins University Bloomberg School of Public Health, Baltimore, MD, USA.
Importance:
Quality improvement (QI) programs for healthcare providers have increased childhood immunization coverage. However, practice-level strategies for adult immunization are less clearly defined and may differ from pediatric approaches.
Objective:
To identify and summarize adult immunization QI programs described in published and unpublished literature.
Evidence Review:
We searched PubMed, Embase, ClinicalTrials.gov, and the Networked Digital Library of Theses and Dissertations in December 2023 using terms covering four main concepts (QI, adults, healthcare providers, and immunization). Results were exported to Covidence for deduplication, screening, and data extraction. Articles describing at least one U.S. adult immunization QI program were included.
Findings:
We included 272 studies. QI programs most frequently targeted influenza (64%) and pneumococcal (43%) vaccines and used patient education (49%), patient reminders (38%), provider reminders (36%), and provider education (35%). Most (81%) of the 212 studies assessing vaccine coverage following QI programs found a statistically significant increase, including 72% of the randomized controlled trials, 85% of the quasi-experimental studies, 89% of the cohort studies, and all of the non-randomized trials and meta-analyses.
Conclusions And Relevance:
Adult immunization QI programs often focus on reminders and education about influenza and pneumococcal vaccines, and they frequently increased adult immunization coverage. Further research is needed to determine the QI components most effective for adult vaccination.
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