Effect of Personalized Messages Sent by a Health System's Patient Portal on Influenza Vaccination Rates: a Randomized Clinical Trial.
Journal
Journal of general internal medicine
ISSN: 1525-1497
Titre abrégé: J Gen Intern Med
Pays: United States
ID NLM: 8605834
Informations de publication
Date de publication:
02 2022
02 2022
Historique:
received:
15
06
2021
accepted:
30
06
2021
pubmed:
3
9
2021
medline:
12
3
2022
entrez:
2
9
2021
Statut:
ppublish
Résumé
Adult influenza vaccination rates are low. Tailored patient reminders might raise rates. Evaluate impact of a health system's patient portal reminders: (1) tailored to patient characteristics and (2) incorporating behavioral science strategies, on influenza vaccination rates among adults. Pragmatic 6-arm randomized trial across a health system during the 2019-2020 influenza vaccination season. The setting was one large health system-53 adult primary care practices. All adult patients who used the patient portal within 12 months, stratified by the following: young adults (18-64 years, without diabetes), older adults (≥65 years, without diabetes), and those with diabetes (≥18 years). Patients were randomized within strata to either (1) pre-commitment reminder alone (1 message, mid-October), (2) pre-commitment + loss frame messages, (3) pre-commitment + gain frame messages, (4) loss frame messages alone, (5) gain frame messages alone, or (6) standard of care control. Patients in the pre-commitment group were sent a message in mid-October, asking if they planned on getting an influenza vaccination. Patients in loss or gain frame groups were sent up to 3 portal reminders (late October, November, and December, if no documented influenza vaccination in the EHR) about importance and safety of influenza vaccine. Receipt of 1 influenza vaccine from 10/01/2019 to 03/31/2020. 196,486 patients (145,166 young adults, 29,795 older adults, 21,525 adults with diabetes) were randomized. Influenza vaccination rates were as follows: for young adults 36.8%, for older adults 55.6%, and for diabetics 60.6%. On unadjusted and adjusted (for age, gender, insurance, race, ethnicity, and prior influenza vaccine history) analyses, influenza vaccination rates were not statistically different for any study group versus control. Patient reminders sent by a health system's patient portal that were tailored to patient demographics (young adults, older adults, diabetes) and that incorporated two behavioral economic messaging strategies (pre-commitment and loss/gain framing) were not effective in raising influenza vaccination rates. This trial was registered with ClinicalTrials.gov (NCT04110314).
Sections du résumé
BACKGROUND
Adult influenza vaccination rates are low. Tailored patient reminders might raise rates.
OBJECTIVE
Evaluate impact of a health system's patient portal reminders: (1) tailored to patient characteristics and (2) incorporating behavioral science strategies, on influenza vaccination rates among adults.
DESIGN
Pragmatic 6-arm randomized trial across a health system during the 2019-2020 influenza vaccination season. The setting was one large health system-53 adult primary care practices.
PARTICIPANTS
All adult patients who used the patient portal within 12 months, stratified by the following: young adults (18-64 years, without diabetes), older adults (≥65 years, without diabetes), and those with diabetes (≥18 years).
INTERVENTIONS
Patients were randomized within strata to either (1) pre-commitment reminder alone (1 message, mid-October), (2) pre-commitment + loss frame messages, (3) pre-commitment + gain frame messages, (4) loss frame messages alone, (5) gain frame messages alone, or (6) standard of care control. Patients in the pre-commitment group were sent a message in mid-October, asking if they planned on getting an influenza vaccination. Patients in loss or gain frame groups were sent up to 3 portal reminders (late October, November, and December, if no documented influenza vaccination in the EHR) about importance and safety of influenza vaccine.
MAIN MEASURES
Receipt of 1 influenza vaccine from 10/01/2019 to 03/31/2020.
KEY RESULTS
196,486 patients (145,166 young adults, 29,795 older adults, 21,525 adults with diabetes) were randomized. Influenza vaccination rates were as follows: for young adults 36.8%, for older adults 55.6%, and for diabetics 60.6%. On unadjusted and adjusted (for age, gender, insurance, race, ethnicity, and prior influenza vaccine history) analyses, influenza vaccination rates were not statistically different for any study group versus control.
CONCLUSIONS
Patient reminders sent by a health system's patient portal that were tailored to patient demographics (young adults, older adults, diabetes) and that incorporated two behavioral economic messaging strategies (pre-commitment and loss/gain framing) were not effective in raising influenza vaccination rates.
TRIAL REGISTRATION
This trial was registered with ClinicalTrials.gov (NCT04110314).
Identifiants
pubmed: 34472020
doi: 10.1007/s11606-021-07023-w
pii: 10.1007/s11606-021-07023-w
pmc: PMC8858355
doi:
Substances chimiques
Influenza Vaccines
0
Banques de données
ClinicalTrials.gov
['NCT04110314']
Types de publication
Journal Article
Randomized Controlled Trial
Research Support, N.I.H., Extramural
Langues
eng
Sous-ensembles de citation
IM
Pagination
615-623Subventions
Organisme : NIAID NIH HHS
ID : R01 AI135029
Pays : United States
Organisme : NIAID NIH HHS
ID : 1R01AI135029-01
Pays : United States
Informations de copyright
© 2021. The Author(s).
Références
Acad Pediatr. 2017 Apr;17(3):330-338
pubmed: 27913163
Am J Epidemiol. 2015 Jan 1;181(1):32-9
pubmed: 25515167
Acad Pediatr. 2018 Mar;18(2):154-160
pubmed: 28826731
J Community Health. 2018 Feb;43(1):201-206
pubmed: 28695426
JAMA. 2012 Apr 25;307(16):1702-8
pubmed: 22535855
Health Psychol. 2007 Nov;26(6):745-52
pubmed: 18020847
J Pers Soc Psychol. 1966 Aug;4(2):195-202
pubmed: 5969145
N Engl J Med. 1982 May 27;306(21):1259-62
pubmed: 7070445
Health Aff (Millwood). 2018 Dec;37(12):1948-1954
pubmed: 30633673
PLoS One. 2017 Jan 26;12(1):e0170550
pubmed: 28125629
Pediatrics. 2021 Aug;148(2):
pubmed: 34321338
Health Commun. 2012;27(8):776-83
pubmed: 22292904
MMWR Recomm Rep. 2020 Aug 21;69(8):1-24
pubmed: 32820746
Pediatrics. 2016 Sep;138(3):
pubmed: 27573088
Med Care. 1975 Jan;13(1):10-24
pubmed: 1089182
JAMA Intern Med. 2020 Jul 1;180(7):962-970
pubmed: 32421168
Vaccine. 2020 Jun 26;38(31):4805-4815
pubmed: 32499068
Am J Prev Med. 2000 Jan;18(1 Suppl):97-140
pubmed: 10806982
J Am Med Inform Assoc. 2020 Jul 1;27(7):989-990
pubmed: 32692845
Br J Soc Psychol. 1989 Mar;28 ( Pt 1):89-94
pubmed: 2706433
Ann Behav Med. 2012 Oct;44(2):171-80
pubmed: 22547155
Patient Educ Couns. 2017 Jun;100(6):1073-1082
pubmed: 28174067
MMWR Recomm Rep. 2018 Aug 24;67(3):1-20
pubmed: 30141464
Pediatrics. 2020 Jul;146(1):
pubmed: 32540985
J Gen Intern Med. 2019 Oct;34(10):2167-2175
pubmed: 31325130
J Pediatr. 2012 Mar;160(3):480-486.e1
pubmed: 22019072
Am J Prev Med. 2012 Jan;42(1):71-5
pubmed: 22176850
Acad Pediatr. 2019 Jan - Feb;19(1):4-10
pubmed: 30172918
Vaccine. 2019 Feb 21;37(9):1168-1173
pubmed: 30709722
J Gen Intern Med. 2018 May;33(5):659-667
pubmed: 29383550
J Pediatr. 2020 Jun;221:123-131.e4
pubmed: 32446470
Cochrane Database Syst Rev. 2018 Jan 18;1:CD003941
pubmed: 29342498
J Abnorm Psychol. 1955 Nov;51(3):629-36
pubmed: 13286010