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Clinical Rheumatology

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Open Access 01-06-2019 | Vaccination | Review Article

Interventions to improve vaccine acceptance among rheumatoid arthritis patients: a systematic review

Authors: Vincent Gosselin Boucher, Ines Colmegna, Claudia Gemme, Sara Labbe, Sandra Pelaez, Kim L. Lavoie

Published in: Clinical Rheumatology | Issue 6/2019

Abstract

Introduction/objective

National guidelines emphasize the importance of annual immunization for patients living with rheumatoid arthritis (RA), but vaccination rates remain suboptimal in this population. Evaluating the efficacy of patient and/or provider-targeted interventions to improve vaccination uptake among RA patients could inform practice.

Methods

We conducted a systematic review (SR) to examine the efficacy of interventions (exposure) aiming to improve vaccination uptake in patients with RA (outcome). English and French language, peer-reviewed interventional studies to improve vaccination rates in RA patients published between 2009 and 2018 were included.

Results

The search yielded a total of 450 records. Five articles met inclusion criteria. All interventions focused on changing provider behavior using some form of vaccination reminder as the primary intervention strategy, though only two studies reported provider prescribing behavior as an outcome (which was 4% and 58%). Overall, studies varied greatly regarding intervention delivery mode (e.g., educational sessions, e-mail reminders, best practice alerts), and behavior change techniques used to encourage providers to prescribe vaccination (e.g., feedback and monitoring, shaping knowledge, self-regulation). For influenza, pneumococcal and herpes zoster, post-intervention (mean 12–16 months follow-up) vaccination rates increased by a mean of 16.6% (± 15.4%).

Conclusions

Interventions to enhance vaccine uptake in RA focused almost exclusively on improving provider prescription of vaccines using reminder-type interventions. Although effective in improving vaccination rates, those studies used heterogeneous interventions and behavior change techniques. Few studies measured provider prescribing behavior as an outcome. Future studies targeting providers should measure relevant provided-related outcomes and their impact on patient outcomes, to determine overall efficacy.

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Title: Interventions to improve vaccine acceptance among rheumatoid arthritis patients: a systematic review
Authors: Vincent Gosselin Boucher
Ines Colmegna
Claudia Gemme
Sara Labbe
Sandra Pelaez
Kim L. Lavoie
Publication date: 01-06-2019
Publisher: Springer London
Keywords: Vaccination
Influenza
Rheumatoid Arthritis
Published in: Clinical Rheumatology / Issue 6/2019
Print ISSN: 0770-3198
Electronic ISSN: 1434-9949
DOI: https://doi.org/10.1007/s10067-019-04430-7

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