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. 1997 Jun;47(419):363–366.

Population-based prevention of influenza in Dutch general practice.

E Hak 1, R P Hermens 1, G A van Essen 1, M M Kuyvenhoven 1, R A de Melker 1
PMCID: PMC1313027  PMID: 9231470

Abstract

BACKGROUND: Although the effectiveness of influenza vaccination in high-risk groups has been proven, vaccine coverage continues to be less than 50% in The Netherlands. To improve vaccination rates, data on the organizational factors, which should be targeted in population-based prevention of influenza, is essential. AIM: To assess the organizational factors in Dutch general practice, which were associated with the influenza vaccination rate in 1994. METHOD: A retrospective questionnaire study was undertaken in 1586 of the 4758 Dutch general practices, which were randomly selected. A total of 1251 (79%) practices returned a questionnaire. The items verified were practice profile, urbanization, delegation index, use of computer-based patient records, influenza vaccination characteristics and influenza vaccination rate. RESULTS: No differences were found with regard to the percentage of single-handed practices (65%), practices situated in urban area (38%), practices with a pharmacy (12%), patients insured by the National Health Service (59%) and use of computer-based patient records (57%) when compared with national statistics. The mean overall influenza vaccination rate was 9.0% (SD 4.0%). Using a logistic regression analysis, a high vaccination rate (> or = 9%) was associated with the use of personal reminders (odds ratio (OR) 1.7, 1.3-2.2), monitoring patient compliance (OR 1.8, 1.3-2.4), marking risk patients in computer-based patient records (OR 1.3, 1.0-1.6), a small number of patients per full-time practice assistant (OR 1.5, 1.1-1.9), urban areas (OR 1.6, 1.3-2.1) and single-handed practices (OR 1.5, 1.1-1.9). CONCLUSION: Improvement of vaccination rates in high-risk patients may be achievable by promoting the use of personal reminders and computer-based patient records, as well as monitoring patient compliance. In addition, the role of practice assistants with regard to preventive activities should be developed further. Practices situated in rural areas and group practices may need more support with a population-based approach for the prevention of influenza.

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Selected References

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  1. Ahmed A. E., Nicholson K. G., Nguyen-Van-Tam J. S. Reduction in mortality associated with influenza vaccine during 1989-90 epidemic. Lancet. 1995 Sep 2;346(8975):591–595. doi: 10.1016/s0140-6736(95)91434-x. [DOI] [PubMed] [Google Scholar]
  2. Connolly A. M., Salmon R. L., Lervy B., Williams D. H. What are the complications of influenza and can they be prevented? Experience from the 1989 epidemic of H3N2 influenza A in general practice. BMJ. 1993 May 29;306(6890):1452–1454. doi: 10.1136/bmj.306.6890.1452. [DOI] [PMC free article] [PubMed] [Google Scholar]
  3. Evans M. R., Wilkinson E. J. How complete is influenza immunization coverage? A study in 75 nursing and residential homes for elderly people. Br J Gen Pract. 1995 Aug;45(397):419–421. [PMC free article] [PubMed] [Google Scholar]
  4. Fiebach N., Beckett W. Prevention of respiratory infections in adults. Influenza and pneumococcal vaccines. Arch Intern Med. 1994 Nov 28;154(22):2545–2557. [PubMed] [Google Scholar]
  5. Fleming D. M., Crombie D. L., Norbury C. A., Cross K. W. Observations on the influenza epidemic of November/December 1989. Br J Gen Pract. 1990 Dec;40(341):495–497. [PMC free article] [PubMed] [Google Scholar]
  6. Hutchison B. G., Shannon H. S. Effect of repeated annual reminder letters on influenza immunization among elderly patients. J Fam Pract. 1991 Aug;33(2):187–189. [PubMed] [Google Scholar]
  7. Leese B., Bosanquet N. Change in general practice and its effects on service provision in areas with different socioeconomic characteristics. BMJ. 1995 Aug 26;311(7004):546–550. doi: 10.1136/bmj.311.7004.546. [DOI] [PMC free article] [PubMed] [Google Scholar]
  8. Middelkoop B. J., Bohnen A. M., Duisterhout J. S., Hoes A. W., Pleumeekers H. J., Prins A. Rotterdam general practitioners report (ROHAPRO): a computerised network of general practices in Rotterdam, The Netherlands. Rotterdam's HuisArtsen Project. J Epidemiol Community Health. 1995 Jun;49(3):231–233. doi: 10.1136/jech.49.3.231. [DOI] [PMC free article] [PubMed] [Google Scholar]
  9. Nguyen-Van-Tam J., Nicholson K. Influenza immunisation: policies and practices of general practitioners in England, 1991/92. Health Trends. 1993;25(3):101–105. [PubMed] [Google Scholar]
  10. Nichol K. L., Margolis K. L., Wuorenma J., Von Sternberg T. The efficacy and cost effectiveness of vaccination against influenza among elderly persons living in the community. N Engl J Med. 1994 Sep 22;331(12):778–784. doi: 10.1056/NEJM199409223311206. [DOI] [PubMed] [Google Scholar]
  11. Nicholson K. G. Immunisation against influenza among people aged over 65 living at home in Leicestershire during winter 1991-2. BMJ. 1993 Apr 10;306(6883):974–976. doi: 10.1136/bmj.306.6883.974. [DOI] [PMC free article] [PubMed] [Google Scholar]
  12. Ohmit S. E., Monto A. S. Influenza vaccine effectiveness in preventing hospitalization among the elderly during influenza type A and type B seasons. Int J Epidemiol. 1995 Dec;24(6):1240–1248. doi: 10.1093/ije/24.6.1240. [DOI] [PubMed] [Google Scholar]
  13. Sadoway D. T., Loucraft J. R., Johnston B. A. Maximizing influenza immunization in Edmonton: a collaborative model. Can J Public Health. 1994 Jan-Feb;85(1):47–50. [PubMed] [Google Scholar]
  14. Sprenger M. J., Diepersloot R. J., Beyer W. E., Masurel N. Influenza-related excess mortality in The Netherlands 1989/90. Lancet. 1990 Aug 11;336(8711):382–382. doi: 10.1016/0140-6736(90)91929-5. [DOI] [PubMed] [Google Scholar]
  15. Sprenger M. J., Masurel N. Influenzavaccinatie en de Postbus 51-campagne. Ned Tijdschr Geneeskd. 1992 Oct 3;136(40):1968–1970. [PubMed] [Google Scholar]
  16. Taylor M. W., Ritchie L. D., Taylor R. J., Ryan M. P., Paterson N. I., Duncan R., Brotherston K. G. General practice computing in Scotland. BMJ. 1990 Jan 20;300(6718):170–172. doi: 10.1136/bmj.300.6718.170. [DOI] [PMC free article] [PubMed] [Google Scholar]
  17. Wiselka M. Influenza: diagnosis, management, and prophylaxis. BMJ. 1994 May 21;308(6940):1341–1345. doi: 10.1136/bmj.308.6940.1341. [DOI] [PMC free article] [PubMed] [Google Scholar]
  18. van Essen G. A., Kuyvenhoven M. M., de Melker R. A. Implementing the Dutch College of General Practitioner's guidelines for influenza vaccination: an intervention study. Br J Gen Pract. 1997 Jan;47(414):25–29. [PMC free article] [PubMed] [Google Scholar]
  19. van der Lei J., Duisterhout J. S., Westerhof H. P., van der Does E., Cromme P. V., Boon W. M., van Bemmel J. H. The introduction of computer-based patient records in The Netherlands. Ann Intern Med. 1993 Nov 15;119(10):1036–1041. doi: 10.7326/0003-4819-119-10-199311150-00011. [DOI] [PubMed] [Google Scholar]

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