"We found that interventions involving team change were effective, especially where nurses had been assigned responsibilities for administering vaccine," the researchers wrote. "Configuring additional personnel so that they are able to relieve physicians of vaccinations seems important to successful team change.
"Additionally, patient outreach may better increase vaccinations to the extent that direct personal contact is achieved. A previous review has similarly reported that reminders involving person-to-person telephone contact were most effective."
Researchers noted that clinician reminders and vaccination education were linked with greater increases in pneumococcal vaccination rates, while audit and feedback appeared more effective for influenza vaccination rates.
"Awareness and support may be less common for pneumococcal than for influenza vaccinations, making pneumococcal vaccinations relatively low-hanging fruit," researchers wrote.
The analysis also noted that few of the interventions improved vaccination rates enough to meet policy targets in North America. And because most of the studies focused on older adults or high-risk non-elderly patients, the researchers cautioned physicians and policymakers to temper expectations of quality improvement when using these interventions.
However, the researchers had advice for physicians in community practice. "Our results suggest that shifting vaccine administration from physicians to members of the primary care team with clear responsibilities for chronic and preventive care and activating patients through personal outreach may stand the best chance of improving vaccination rates in community dwelling adults."
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