Provider Intervention Leads to Increased Flu Vaccination Rates Among Patients With COPD

Physician and nurse interventions are the most effective means of promoting influenza vaccinations among patients with chronic obstructive pulmonary disease (COPD), according to the results of a pilot project. Conducted at the National University Hospital in Singapore, the project is the most extensive prospective study of its kind aimed at increasing vaccination rates in patients with COPD.

The influenza virus, rhinovirus, and respiratory syncytial virus are the most common viral infections among patients with COPD.

Of the 348 participating patients, researchers found the initial baseline vaccination rate to be more than 47% while the final rate was nearly 81%. They also found that regular flu vaccinations reduced COPD exacerbations, which are one of the leading causes of hospitalizations around the globe and carry a mortality rate as high as 20%. In the United States, vaccination rates among people with COPD range between 20% and 60%.

To lower the number of people who did not receive their vaccination and decrease rates of infective exacerbations, researchers collected data from one of Singapore’s tertiary referral hospitals. Patients with COPD were enrolled in an “integrated nurse-led, specialist-supported” program called TAP. The program started in 2013 and researchers followed up with patients in 2015.

Physicians and nurses used various tactics to boost immunization rates. For example, physicians explaining the importance of immunizations and, in some cases, nurses following up with those who didn’t get their vaccinations. Patients and providers also completed surveys and questionnaires distributed at the time of vaccination to determine which intervention methods were the most successful.  

Physician intervention accounted for nearly 88% of the increase in vaccinations, with the remaining increase due to nurse reminders.

Researchers said local settings might contribute to the findings. Influenza vaccination awareness is low in Singapore. Those with COPD also were older and had poor health literacy. Also, because doctors knew patients’ vaccination rates would be monitored during the study, physicians consciously made an effort to address the issue, which may have improved the rates of vaccinations.

For additional information about the study, visit AJMC.