Implementing the evidence: Are call/recall systems for immunisations feasible in general practice?

Abstract

Vaccines are effective against a range of infectious diseases but suboptimal rates of immunisation continue to cause serious illness and deaths.1 Immunisation coverage is determined by a number of factors related to service provision, healthcare workers and individuals’ beliefs, knowledge and attitudes. Patient invite-reminder systems (also known as call/recall) are consistently cited as being one of the most cost-effective ways to improve uptake of vaccination services.2,3 By call/recall, we mean the process that healthcare providers utilise to systematically identify individuals eligible for immunisation, invite them to book or attend an appointment, remind them to attend and follow up those who have not attended or responded. Various systematic reviews4-9 have assessed the effectiveness of invitereminder systems in improving immunisation coverage, with a recent Cochrane review estimating that it can increase uptake by 8%.10 While invite-reminders are ideally suited to individuals who may forget appointments, they also help encourage those individuals who may be more hesitant to take up an immunisation.11 Depending on how it is set up, an invite-reminder system can optimise uptake in a costeffective manner. Using automated lower-cost methods (e.g. texts) for the whole population with more resource-heavy approaches for more defined cohorts (e.g. phone calls) can help strike the right balance between optimising uptake and minimising cost.12