Abstract：
It is urgent to implement interventions to increase vaccination rates of influenza/pneumonia vaccines in older adults, yet the effectiveness of different intervention strategies has not been thoroughly evaluated.
We aimed to assess the effectiveness of intervention strategies for increasing the coverage of influenza/pneumonia vaccination in older adults.
PubMed, Web of Science, Cochrane Library, Embase, China Biology Medicine disc, China National Knowledge Infrastructure and Wanfang were searched from 1 January 2000 to 1 October 2022. RCTs that assessed any intervention strategies for increasing influenza/pneumonia vaccination coverage or willingness in older adults were included. A series of random-effects network meta-analysis was conducted by using frequentist frameworks.
Twenty-two RCTs involving 385,182 older participants were eligible for further analysis. Eight types of intervention strategies were evaluated. Compared with routine notification, health education (odds ratio [OR], 1.85 [95%CI, 1.19 to 2.88]), centralised reminder (OR, 1.63 [95%CI, 1.07 to 2.47]), health education + onsite vaccination (OR, 2.89 [95%CI, 1.30 to 6.39]), and health education + centralised reminder + onsite vaccination (OR, 20.76 [95%CI, 7.33 to 58.74]) could effectively improve the vaccination rate. The evidence grade was low or very low due to the substantial heterogeneity among studies.
Our findings suggest that health education + centralised reminder + onsite vaccination may potentially be an effective strategy regardless of cost, but the evidence level was low. More rigorous trials are needed to identify the association between strategies and vaccination rates among older adults and to integrate such evidence into clinical care to improve vaccination rates.
We aimed to assess the effectiveness of intervention strategies for increasing the coverage of influenza/pneumonia vaccination in older adults.
PubMed, Web of Science, Cochrane Library, Embase, China Biology Medicine disc, China National Knowledge Infrastructure and Wanfang were searched from 1 January 2000 to 1 October 2022. RCTs that assessed any intervention strategies for increasing influenza/pneumonia vaccination coverage or willingness in older adults were included. A series of random-effects network meta-analysis was conducted by using frequentist frameworks.
Twenty-two RCTs involving 385,182 older participants were eligible for further analysis. Eight types of intervention strategies were evaluated. Compared with routine notification, health education (odds ratio [OR], 1.85 [95%CI, 1.19 to 2.88]), centralised reminder (OR, 1.63 [95%CI, 1.07 to 2.47]), health education + onsite vaccination (OR, 2.89 [95%CI, 1.30 to 6.39]), and health education + centralised reminder + onsite vaccination (OR, 20.76 [95%CI, 7.33 to 58.74]) could effectively improve the vaccination rate. The evidence grade was low or very low due to the substantial heterogeneity among studies.
Our findings suggest that health education + centralised reminder + onsite vaccination may potentially be an effective strategy regardless of cost, but the evidence level was low. More rigorous trials are needed to identify the association between strategies and vaccination rates among older adults and to integrate such evidence into clinical care to improve vaccination rates.
摘要：
背景：迫切需要实施干预措施，以提高老年人的流感/肺炎疫苗接种率，然而,不同干预策略的有效性尚未得到全面评估.
目的：我们旨在评估增加老年人流感/肺炎疫苗接种的干预策略的有效性。
方法：PubMed，WebofScience,科克伦图书馆,Embase,中国生物医药光盘,从2000年1月1日至2022年10月1日搜索了中国国家知识基础设施和万方。纳入评估任何增加老年人流感/肺炎疫苗接种覆盖率或意愿的干预策略的随机对照试验。使用频率论框架进行了一系列随机效应网络元分析。
结果：涉及385,182名老年参与者的22项随机对照试验符合进一步分析的条件。评估了八种类型的干预策略。与常规通知相比，健康教育(比值比[OR]，1.85[95CI，1.19至2.88])，集中式提醒(或，1.63[95CI，1.07至2.47])，健康教育+现场疫苗接种(或，2.89[95CI，1.30至6.39])，和健康教育+集中提醒+现场疫苗接种(或，20.76[95CI，7.33至58.74]）可以有效提高疫苗接种率。由于研究之间的实质性异质性，证据等级较低或非常低。
结论：我们的研究结果表明，无论成本如何，健康教育+集中提醒+现场疫苗接种可能是一种有效的策略，但证据水平很低.需要更严格的试验来确定老年人的策略和疫苗接种率之间的关联，并将这些证据纳入临床护理以提高疫苗接种率。
目的：我们旨在评估增加老年人流感/肺炎疫苗接种的干预策略的有效性。
方法：PubMed，WebofScience,科克伦图书馆,Embase,中国生物医药光盘,从2000年1月1日至2022年10月1日搜索了中国国家知识基础设施和万方。纳入评估任何增加老年人流感/肺炎疫苗接种覆盖率或意愿的干预策略的随机对照试验。使用频率论框架进行了一系列随机效应网络元分析。
结果：涉及385,182名老年参与者的22项随机对照试验符合进一步分析的条件。评估了八种类型的干预策略。与常规通知相比，健康教育(比值比[OR]，1.85[95CI，1.19至2.88])，集中式提醒(或，1.63[95CI，1.07至2.47])，健康教育+现场疫苗接种(或，2.89[95CI，1.30至6.39])，和健康教育+集中提醒+现场疫苗接种(或，20.76[95CI，7.33至58.74]）可以有效提高疫苗接种率。由于研究之间的实质性异质性，证据等级较低或非常低。
结论：我们的研究结果表明，无论成本如何，健康教育+集中提醒+现场疫苗接种可能是一种有效的策略，但证据水平很低.需要更严格的试验来确定老年人的策略和疫苗接种率之间的关联，并将这些证据纳入临床护理以提高疫苗接种率。
