Several vaccines are funded for adults under the Australian National Immunisation Program (NIP), including influenza, pneumococcus and zoster. However, coverage of NIP vaccines recommended for adults, especially those medically at risk, is suboptimal.
UNSW is investigating the impact of using Topbar clinical decision support to opportunistically match under-vaccinated adults, and invite vaccination for patients eligible for influenza, pneumococcal and herpes zoster vaccines, during consultation. In parallel, the Pen CS’ Clinical Audit Tool (CAT4) is being employed to identify eligible unvaccinated patients in the practice to facilitate recall and reminder interventions by SMS voice and text messaging.
The aim is to increase coverage of NIP vaccines recommended for adults, especially those medically at risk. National vaccination coverage in those aged ≥65 years is approximately 75% for influenza and 55% for pneumococcal. For adults aged <65 years with medical risk factors, coverage is approximately 30%, for Aboriginal and Torres Strait Islander people aged ≥15 years influenza coverage is approximately 30%. These groups combined include >95% of Australians who have not received a vaccine for which they are eligible under the National Immunisation Program (NIP), or almost 4 million people.
Pen CS caught up with Dr Rob Menzies, School of Public Health and Community Medicine, University of New South Wales.
Q. How is the program tracking?
A. Well. We’re finalising the IT platform here at the University and waiting for final approval from the ethics committee. We aim to have the new Topbar alerts available in 4 pilot practices by the time influenza vaccine becomes available in mid-April.
Q. What has been the response from participating General Practices?
A. There are several that are keen to participate and we’ll be finalising that in the next couple of weeks.
Q. What are you hoping to achieve with this study?
A. We hope the Topbar alert will increase opportunistic vaccination of patients who come in for another reason. We are particularly keen to see the impact for younger adults with medical risk conditions. Its easier for influenza vaccination to slip the mind of a provider for this group, trying to remember all the relevant risk conditions, and this is where Topbar can help by identifying them from data in the electronic medical record.
Q. Could it be scaled to include other General Practices?
A. Definitely. If it proves useful we’d like to see it available to all PAT CAT users.
Q. What would be required to make this happen?
A. Just Pen to roll out an update.
Q. Any thoughts/messages you’d like to share?
A. If your practice would like to participate, let Pen know and they will pass on your details.