文摘
背景:改进的高危人群流感和肺炎球菌疫苗接种是预防保健为初级卫生保健团队的一个重要方面。目的:探讨教育推广的效果去初级卫生保健团队流感和肺炎球菌疫苗接种吸收在高危病人。设计:集群随机对照试验。设置:在英国特伦特地区,三十一般实践。方法:随机干预和15 15实践后对照组分层基线的疫苗接种率。提供和接收所有干预行为是一个教育拓展访问主要医疗团队,除了审计和反馈针对提高流感和肺炎球菌疫苗接种率在高危人群。仅接受审计和反馈控制实践。所有实践测量流感和肺炎球菌疫苗接种率在高危人群。主要结果改进疫苗接种率65岁的病人,和冠心病(CHD)患者,糖尿病和脾切除术的历史。结果:改进的肺炎球菌疫苗接种率干预实践明显更大与控制冠心病患者相比,14.8%和6.5%(比值比(或)= 1.23,95%可信区间[CI] = 1.13 - 1.34)和糖尿病,15.5%比6.8%(或= 1.18,95% CI = 1.08 - 1.29)但不是脾切除术,6.5%比4.7%(或= 0.96,95% CI = 0.65 - 1.42)。 Improvements for influenza vaccination were also usually greater in intervention practices but did not reach statistical significance. The increases for influenza vaccination in intervention versus control practices were for CHD, 18.1% versus 13.1% (OR = 1.06, 95% CI = 0.99 to 1.12); diabetes, 15.5% versus 12.0% (OR = 1.07, 95% CI = 0.99 to 1.16), splenectomy 16.1% versus 2.9% (OR = 1.22, 95% CI = 0.78 to 1.93); and those over 65 years 20.7% versus 25.4% (OR = 0.99, 95% CI = 0.96 to 1.02). CONCLUSION: Practices where primary care teams received an educational outreach visit demonstrated a significantly greater improvement in uptake in high-risk groups for pneumococcal but not influenza vaccine.