Promotion of Influenza Vaccination in the Emergency Department.

Autor:	Rodriguez RM; Department of Emergency Medicine, University of California, San Francisco, San Francisco., Eucker SA; Department of Emergency Medicine, Duke University, Durham, NC., Rafique Z; Henry J.N. Taub Department of Emergency Medicine, Baylor College of Medicine, Houston., Nichol G; University of Washington-Harborview Center for Prehospital Emergency Care, Seattle., Molina MF; Department of Emergency Medicine, University of California, San Francisco, San Francisco., Kean E; Department of Emergency Medicine, Thomas Jefferson University, Philadelphia., O'Laughlin KN; Department of Emergency Medicine, University of Washington, Seattle., Bezek SK; Henry J.N. Taub Department of Emergency Medicine, Baylor College of Medicine, Houston., Goicochea K; Department of Emergency Medicine, Duke University, Durham, NC., Ford JS; Department of Emergency Medicine, University of California, San Francisco, San Francisco., Morse D; Department of Emergency Medicine, University of Washington, Seattle., White J; Department of Emergency Medicine, Duke University, Durham, NC., Arreguin MI; Department of Emergency Medicine, University of California, San Francisco, San Francisco., Shughart L; Department of Emergency Medicine, Thomas Jefferson University, Philadelphia., Chavez CL; Department of Emergency Medicine, University of California, San Francisco, San Francisco., Glidden DV; Department of Epidemiology & Biostatistics, University of California, San Francisco, San Francisco., Rising KL; Department of Emergency Medicine, Thomas Jefferson University, Philadelphia.
Jazyk:	angličtina
Zdroj:	NEJM evidence [NEJM Evid] 2024 Apr; Vol. 3 (4), pp. EVIDoa2300197. Date of Electronic Publication: 2024 Mar 26.
DOI:	10.1056/EVIDoa2300197
Abstrakt:	Background: Influenza vaccine uptake is low among underserved populations whose primary health care access occurs in emergency departments. We sought to determine whether implementation of two interventions would increase 30-day influenza vaccine uptake in unvaccinated patients in the emergency department. Methods: This three-group, prospective, cluster-randomized controlled trial compared two interventions with a control group in noncritically ill, adult patients in the emergency department who were not vaccinated for influenza in the current vaccine season. The unit of randomization was individual calendar days. Participants received either Intervention M (an influenza vaccine messaging platform consisting of a video, one-page flyer, and scripted message, followed by a vaccine acceptance question and provider notification if participants indicated vaccine acceptance), Intervention Q (no messaging but the vaccine acceptance question and provider notification), or control (usual care/no intervention). The primary outcome was receipt of an influenza vaccine at 30 days ascertained by electronic health record review and telephone follow-up, comparing the Intervention M group with the control group. Secondary outcomes included comparisons of 30-day vaccine uptake in Intervention Q versus control and Intervention M versus Intervention Q. Results: Between October 2022 and February 2023, a total of 767 trial participants were enrolled at six emergency departments in five U.S. cities. Median age was 46 years; 353 (46%) participants were female, 274 (36%) were African American, and 158 (21%) were Latinx; 126 (16%) lacked health insurance, and 244 (32%) lacked primary care. The Intervention M, Intervention Q, and control groups had 30-day vaccine uptakes of 41%, 32%, and 15%, respectively (P<0.0001 for Intervention M vs. control). Comparing Intervention M versus Intervention Q, the adjusted difference in 30-day vaccine uptake was 8.7 percentage points (95% confidence interval, -0.1 to 17.6 percentage points). Conclusions: Implementation of influenza vaccine messaging platforms (video clips, printed materials, and verbal scripts) improved 30-day vaccine uptake among unvaccinated patients in the emergency department. (Funded by the National Institute of Allergy and Infectious Diseases; ClinicalTrials.gov number, NCT05836818.).
Databáze:	MEDLINE
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