Impact of intensive health education on influenza vaccination and acute exacerbations in outpatients with chronic obstructive pulmonary disease: a real-world study.

Abstract

Background: The influenza vaccination rate of chronic obstructive pulmonary disease (COPD) patients in China was very low. In this study, we aimed to evaluate the effect of clinician-led intensive health education on influenza vaccination in outpatients with COPD and the effect of influenza vaccination on the risk of acute exacerbations in the real world.

Methods: Participants were from the Real World Research of Diagnosis and Treatment of COPD study, a real-world prospective cohort study. COPD patients were included from December 2016 to April 2023 and followed up for one year. In January 2022, clinicians began strengthening health education for outpatients with COPD. We identified patients visiting the clinic from January 2022 to April 2023 as the intensive health education group and those visiting from December 2016 to December 2021 as the control group. We analysed factors associated with influenza vaccination and the effect of influenza vaccine on acute exacerbations by multivariate analysis.

Results: 7834 patients were included. Compared with the control group, the intensive health education group had a higher rate of influenza vaccination (1.6% vs. 12.2%, P < 0.01). Smoking cessation, high school education or above, influenza vaccination in the past year and intensive health education were independently associated with influenza vaccination. Influenza vaccination reduced the incidence of future acute exacerbations (adjusted odds ratio (aOR) = 0.48; 95% confidence interval (CI) = 0.33-0.68, P < 0.01), frequent acute exacerbations (aOR = 0.47; 95% CI = 0.27-0.82, P = 0.01), and severe acute exacerbation (aOR = 0.38; 95% CI = 0.23-0.63, P < 0.01) in COPD patients.

Conclusions: Influenza vaccination reduced the risk of future acute exacerbations in patients with COPD. Clinician-led intensive health education can improve the influenza vaccination of outpatients with COPD, and clinicians and policymakers should pay attention to and apply this method.