Dorothea Dehnen, Maia Milzkott, Benjamin Borchardt, Anette Graute, Katja Dehnen, Kerstin Herzer, Katharina Willuweit, Anna Herwig, Jassin Rashidi-Alavijeh, Birgitta Weltermann
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The intervention consisted of a yellow information letter, which was personalized and sent to either the patient (1), the family physician (2), or both (3) in December 2016.</p>\n </section>\n \n <section>\n \n <h3> Results</h3>\n \n <p>Irrespective of the assigned intervention group, a significant increase in vaccination rates from baseline to follow-up after 2 years was observed for tetanus (53%–56%), pertussis (52%–57%), hepatitis A (44%–49%), hepatitis B (64%–71%), pneumococci (68%–75%), and the sequential pneumococcal vaccination (12%–22%). Comparing the interventions, the vaccination rate for hepatitis A was significantly higher at follow-up for intervention (3) (OR = 9.07, <i>p</i> = 0.043) and (2) (OR = 9.91, <i>p</i> = 0.034) than for intervention (1). Concerning the vaccination rate for hepatitis B, an odds ratio of 9.13 was observed for intervention (2) (<i>p</i> = 0.006) compared to (1). Interventions (2) and (3) were generally superior to the patient-centered intervention alone, with the exception of influenza vaccination.</p>\n </section>\n \n <section>\n \n <h3> Conclusion</h3>\n \n <p>The results show the importance of family physicians in improving vaccination rates in liver transplant recipients. Establishing low-threshold communication channels, for example, via the electronic patient record, could improve cooperation between physicians in specialized outpatient clinics and family physicians.</p>\n </section>\n \n <section>\n \n <h3> Trial Registration</h3>\n \n <p>German Clinical Trials Register (DRKS: DRKS00035422). 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引用次数: 0
摘要
背景免疫抑制肝移植受者的疫苗接种率有待提高。我们比较了三组随机干预对肝移植受者疫苗接种率的影响。方法289例肝移植受者随机分为患者干预组、家庭医生干预组和患者与家庭医生联合干预组。干预包括一封黄色信息信，该信息信是个性化的，并于2016年12月发送给患者(1)、家庭医生(2)或两者(3)。结果无论指定的干预组如何，2年后从基线到随访，破伤风（53%-56%）、百日咳（52%-57%）、甲型肝炎（44%-49%）、乙型肝炎（64%-71%）、肺炎球菌（68%-75%）和顺序肺炎球菌疫苗接种（12%-22%）的疫苗接种率显著增加。与干预措施相比，干预措施(3)和(2)在随访时的甲型肝炎接种率显著高于干预措施(1)（OR = 9.07, p = 0.043）和（OR = 9.91, p = 0.034）。关于乙肝疫苗接种率，干预组(2)与干预组(1)的比值比为9.13 （p = 0.006）。除流感疫苗接种外，干预措施(2)和(3)一般优于单独以患者为中心的干预措施。结论家庭医生对提高肝移植受者疫苗接种率的重要性。建立低门槛的沟通渠道，例如通过电子病历，可以改善专科门诊医生和家庭医生之间的合作。德国临床试验注册（DRKS: DRKS00035422）。由于时间限制和缺乏人力资源，登记是回顾性的。
Effectiveness of a Personal Vaccination Recommendation Letter to Liver Transplant Patients and Family Physicians for Improving the Vaccination Status
Background
Vaccination rates of immunosuppressed liver transplant recipients need to improve. We compared the effectiveness of a three-arm randomized intervention on vaccination rates in liver transplant recipients.
Methods
Two hundred and eighty-nine liver transplant recipients were randomly assigned to three groups: (1) patient intervention, (2) family physician intervention, and (3) combined patient and family physician intervention. The intervention consisted of a yellow information letter, which was personalized and sent to either the patient (1), the family physician (2), or both (3) in December 2016.
Results
Irrespective of the assigned intervention group, a significant increase in vaccination rates from baseline to follow-up after 2 years was observed for tetanus (53%–56%), pertussis (52%–57%), hepatitis A (44%–49%), hepatitis B (64%–71%), pneumococci (68%–75%), and the sequential pneumococcal vaccination (12%–22%). Comparing the interventions, the vaccination rate for hepatitis A was significantly higher at follow-up for intervention (3) (OR = 9.07, p = 0.043) and (2) (OR = 9.91, p = 0.034) than for intervention (1). Concerning the vaccination rate for hepatitis B, an odds ratio of 9.13 was observed for intervention (2) (p = 0.006) compared to (1). Interventions (2) and (3) were generally superior to the patient-centered intervention alone, with the exception of influenza vaccination.
Conclusion
The results show the importance of family physicians in improving vaccination rates in liver transplant recipients. Establishing low-threshold communication channels, for example, via the electronic patient record, could improve cooperation between physicians in specialized outpatient clinics and family physicians.
Trial Registration
German Clinical Trials Register (DRKS: DRKS00035422). Registration was done retrospectively due to time constraints and lack of human resources.
期刊介绍：
Clinical Transplantation: The Journal of Clinical and Translational Research aims to serve as a channel of rapid communication for all those involved in the care of patients who require, or have had, organ or tissue transplants, including: kidney, intestine, liver, pancreas, islets, heart, heart valves, lung, bone marrow, cornea, skin, bone, and cartilage, viable or stored.
Published monthly, Clinical Transplantation’s scope is focused on the complete spectrum of present transplant therapies, as well as also those that are experimental or may become possible in future. Topics include:
Immunology and immunosuppression;
Patient preparation;
Social, ethical, and psychological issues;
Complications, short- and long-term results;
Artificial organs;
Donation and preservation of organ and tissue;
Translational studies;
Advances in tissue typing;
Updates on transplant pathology;.
Clinical and translational studies are particularly welcome, as well as focused reviews. Full-length papers and short communications are invited. Clinical reviews are encouraged, as well as seminal papers in basic science which might lead to immediate clinical application. Prominence is regularly given to the results of cooperative surveys conducted by the organ and tissue transplant registries.
Clinical Transplantation: The Journal of Clinical and Translational Research is essential reading for clinicians and researchers in the diverse field of transplantation: surgeons; clinical immunologists; cryobiologists; hematologists; gastroenterologists; hepatologists; pulmonologists; nephrologists; cardiologists; and endocrinologists. It will also be of interest to sociologists, psychologists, research workers, and to all health professionals whose combined efforts will improve the prognosis of transplant recipients.
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