Effects of a multi-faceted program to increase influenza vaccine uptake among health care workers in nursing homes: A cluster randomised controlled trial

Abstract

Effects of a multi-faceted program to increase influenza vaccine uptake among health care workers in nursing homes Looijmans-van den Akker, I.; van Delden, J.J.M.; Verheij, T.J.M.; van der Sande, M.A.B.; van Essen, G.A.; Riphagen-Dalhuisen, J.; Hulscher, M.E.; Hak, E. Take-down policy If you believe that this document breaches copyright please contact us providing details, and we will remove access to the work immediately and investigate your claim.Downloaded from the University of Groningen/UMCG research database (Pure): http://www.rug.nl/research/portal. For technical reasons the number of authors shown on this cover page is limited to 10 maximum. AbstractInfluenza causes substantial mortality in high-risk groups despite targeted vaccination programmes. This paper considers whether it is worth vaccinating healthcare workers (HCWs) against influenza to protect high-risk patients in a series of systematic reviews and an economic evaluation. Eighteen studies are included. Vaccination was highly effective in HCWs, with minimal adverse effects. Two trials assessed patient mortality after vaccinating HCWs, both of which showed a reduction. Despite recommendations, less than 25% of HCW in Europe and the UK are vaccinated. Five studies looked at programmes to increase uptake; these produced increases of 5%-45%. Published economic evaluations did not include patient benefit; therefore, an economic evaluation using UK data was undertaken. In the base case, vaccination was cost saving (£12/vaccinee). In the most pessimistic scenario it cost £405/life-year gained. Effective implementation should be a priority.

Interventions to increase seasonal influenza vaccine coverage in healthcare workers: A systematic review and meta-regression analysis

“…41 Allocation concealment in the 2 RCTs was unclear, 35,53 5 studies did not report vaccination coverage at baseline for the intervention and control groups, 34,35,37,47,53 and 9 studies (including the 3 controlled BnA studies) did not sufficiently report on potential baseline imbalances. 34 26,41,47,49,58 and in 3 of them the response rate was low enough to potentially bias the results. 41,47,58 Most studies offered vaccination in-house and could objectively ascertain vaccine coverage 26,35,36,49,53,64,68,71 ; one study used an external occupational health service, 37 another used general practitioner claim forms, 34 3 studies used self-report via quesionnaires to ascertain vaccination, 41,47,58 and one study did not report the method of ascertainment.…”

“…34 26,41,47,49,58 and in 3 of them the response rate was low enough to potentially bias the results. 41,47,58 Most studies offered vaccination in-house and could objectively ascertain vaccine coverage 26,35,36,49,53,64,68,71 ; one study used an external occupational health service, 37 another used general practitioner claim forms, 34 3 studies used self-report via quesionnaires to ascertain vaccination, 41,47,58 and one study did not report the method of ascertainment. 51 Of the uncontrolled BnA studies, none described particular concurrent events that could influence the post-intervention vaccination coverage, except in the 2 studies that reported a vaccine shortage during the previous year 43,56 ; although in these the comparison was made with the second-to-last year, the shortage might still have biased the post-intervention vaccination coverage.…”

How to develop a program to increase influenza vaccine uptake among workers in health care settings?

“…We used this IM method to systematically develop an intervention program to change vaccination behaviour among HCWs that could be implemented in nursing homes in the Netherlands. In an earlier report, we showed a mean 9% increase of vaccine uptake among HCWs in nursing homes that implemented the systematically developed program compared with control homes, with higher rates in those homes that implemented more program elements [20]. Here, we report in detail the process of the development of the implementation program to enable researchers and practitioners to develop intervention programs tailored to their setting.…”

Do the quality of the trials and the year of publication affect the efficacy of intervention to improve seasonal influenza vaccination among healthcare workers?: Results of a systematic review

“…When only taking into consideration studies that scored 3 or higher on the JADAD scale 5,14,15,16,17,18 5). …”

“…In contrast, in the study by Dey et al (2001), 14 participants were separated in two groups: those that worked in Primary Health Care Teams (PHCT) and those that worked in Nursing Homes (NH). Also, in the study conducted by Looijmans-van den Akker (2010), 17 health care workers were divided into three groups: physicians, nurses and nursing assistants.…”