Effectiveness of a co-ordinated nation-wide programme to improve influenza immunisation rates in The Netherlands

E Hak, R P Hermens, A W Hoes, T J Verheij, M M Kuyvenhoven, G A van Essen

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    OBJECTIVE: To assess t he effectiveness of a nation-widemultifaceted intervention programme involving general practitioners (GPs) on influenza immunisation practice.

    DESIGN: Pragmatic before-after trial using pre- and post-measurement questionnaires.

    SETTING AND SUBJECTS: Random sample of Dutch general practices.

    INTERVENTION: During a 2.5-year period (1995-1997) a variety of methods was implemented to enhance physician adoption of the immunisation guideline, including employment of facilitators, information-based methods, small-group consensus meetings, individual instructions and introduction of supportive computer software.

    MAIN OUTCOME MEASURES: Influenza immunisation practice and influenza vaccine uptake.

    RESULTS: In 988 practices all influenza vaccination characteristics markedly improved from 1995 to 1997. The most significant changes were found in computerised marking of high-risk patients (from 54% to 82% of practices), computerised selection (41% to 77%) and sending personal reminders (40% to 77%). Vaccine uptake increased from 9% to 16% of the practice population (78% increase, p < 0.001). Uptake was most prominent in urban and single-handed practices and in those with more patients insured through the National Health Service, low GP workload and low baseline uptake.

    CONCLUSION: Our data suggest that a co-ordinated approach involving primary care physicians can succeed in enlarging the public health impact of a population-based preventive measure.

    Original languageEnglish
    Pages (from-to)237-241
    Number of pages5
    JournalScandinavian Journal of Primary Health Care
    Issue number4
    Publication statusPublished - Dec-2000


    • Analysis of Variance
    • Family Practice
    • Humans
    • Immunization Programs
    • Influenza, Human
    • National Health Programs
    • Netherlands
    • Physician's Practice Patterns
    • Practice Guidelines as Topic
    • Program Evaluation
    • Prospective Studies
    • Statistics, Nonparametric

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