People with diabetes often have weakened immune systems, which increases their risk of infection, illnesses, and complications from illnesses—including influenza. Some estimates suggest that these patients are up to six times more likely to be hospitalized from the flu. Therefore, it is particularly important that people with diabetes get vaccinated.
A recent study in the journal Clinical Audit found that contacting patients with flu shot reminders increased vaccine uptake in patients with diabetes by 20%. In the year prior to the study, there was only a 8% increase in the number of diabetic patients vaccinated during the window covered by the intervention—highlighting the potential benefit of such calls for this population.
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Woman receiving flu shot. Source: Getty
The authors reviewed electronic patient records at a general medical practice in East London, and identified the diabetic patients who records showed had not received a flu vaccination. Of the 393 patients in that group, 12 had incorrect or incomplete contact information, and were not included in the study.
The first round of calls were made to the patients on the list over a two week period in the fall of 2017. Of those calls, 17 patients reported that they had booked an appointment for a flu shot, 14 booked a flu shot, and 11 said that they’d book an appointment at a later date. Fourteen people declined a flu shot, and 222 said that they’d already received a flu shot.
After the first set of calls, there were 105 patients who had not received or declined the flu shot. A second call was made during the next two weeks: three patients booked a flu shot, five indicated that they would book at a later date, and 38 said that they had already received the shot. Nine people declined a flu shot.
Finally, the 88 patients who remained unvaccinated after the two rounds of calls were sent an email. However, only 29 patients had email addresses available. Seven of those patients received the flu shot.
Of the 23 people who declined the flu shot during the two calls, the majority gave no reason. However, some patients reported that they had bad experiences with the flu shot in the past, and others said that they were waiting until it was colder to get the shot—revealing that there were misconceptions about the flu shot in their patient group.
The researchers noted that as their study center was located in an ethnically diverse part of London, language barriers made phone conversations challenging, particularly with patients who declined to receive the flu shot.
Other barriers included incorrect or missing phone numbers and email addresses, which put patients at risk of missing all health care reminders—not just those from this intervention. “This has the potential to be detrimental to their health, particularly in this patient group (diabetics) who require constant follow-up and checks to ensure optimum health,” they wrote.
The success of the program, and the marked increase in flu vaccination, highlights the importance of streamlining patient communication.
“Further work needs to be done on the impact of patient notification, including feedback from patients as to...what the best modes of contacting them are,” the authors concluded.
