Assessing the impact of shared decision making processes on influenza vaccination rates in adult patients in outpatient care: A systematic review and meta-analysis.
Adult
Influenza
Shared decision making
Systematic review
Vaccination
Journal
Vaccine
ISSN: 1873-2518
Titre abrégé: Vaccine
Pays: Netherlands
ID NLM: 8406899
Informations de publication
Date de publication:
08 01 2021
08 01 2021
Historique:
received:
24
08
2020
revised:
30
11
2020
accepted:
02
12
2020
pubmed:
19
12
2020
medline:
28
4
2021
entrez:
18
12
2020
Statut:
ppublish
Résumé
Shared decision making (SDM) is a promising approach, to bridge major barriers concerning vaccination by patient education and personal interaction of health care provider (HCP) and patient. SDM affects patient adherence, enhances patient knowledge, decreases decisional conflict and improves trust in the physician in most areas of health care. The shared decision making process (SDM process) is characterised by three key components: patient activation, bi-directional exchange of information and bi-directional deliberation of options. To assess the impact of SDM processes on influenza vaccination rates in outpatient care patients. A systematic literature search in MEDLINE, CENTRAL, EMBASE, PsycINFO and ERIC was conducted (2020-02-05). Randomized controlled trials (RCTs) and cluster RCTs, that aimed to improve influenza vaccination rates in adult patients in outpatient care were included. We examined effects of SDM processes on influenza vaccination rates by meta-analysis, and considered the extent of SDM processes in the analysed interventions and possible effect modifiers in subgroup analyses. We included 21 studies, with interventions including face-to-face sessions, telephone outreach, home visits, Health Care Practitioner (HCP) trainings and supporting educational material. In 12 studies, interventions included all elements of a SDM process. A meta-analysis of 15 studies showed a positive effect on vaccination rates (OR of 1.96 (95% CI: 1.31 to 2.95)). Findings further suggest that interventions are effective across different patients groups and could increase effectiveness when the interaction is facilitated by multidisciplinary teams of HCP in comparison to interventions delivered by individual HCP. This systematic review and meta-analysis provide evidence that SDM processes can be an effective strategy to increase influenza vaccination rates. Further research with more detailed descriptions of SDM implementation modalities is necessary to better understand which components of SDM are most effective. PROSPERO: CRD42020175555.
Sections du résumé
BACKGROUND
Shared decision making (SDM) is a promising approach, to bridge major barriers concerning vaccination by patient education and personal interaction of health care provider (HCP) and patient. SDM affects patient adherence, enhances patient knowledge, decreases decisional conflict and improves trust in the physician in most areas of health care. The shared decision making process (SDM process) is characterised by three key components: patient activation, bi-directional exchange of information and bi-directional deliberation of options.
OBJECTIVES
To assess the impact of SDM processes on influenza vaccination rates in outpatient care patients.
METHODS
A systematic literature search in MEDLINE, CENTRAL, EMBASE, PsycINFO and ERIC was conducted (2020-02-05). Randomized controlled trials (RCTs) and cluster RCTs, that aimed to improve influenza vaccination rates in adult patients in outpatient care were included. We examined effects of SDM processes on influenza vaccination rates by meta-analysis, and considered the extent of SDM processes in the analysed interventions and possible effect modifiers in subgroup analyses.
RESULTS
We included 21 studies, with interventions including face-to-face sessions, telephone outreach, home visits, Health Care Practitioner (HCP) trainings and supporting educational material. In 12 studies, interventions included all elements of a SDM process. A meta-analysis of 15 studies showed a positive effect on vaccination rates (OR of 1.96 (95% CI: 1.31 to 2.95)). Findings further suggest that interventions are effective across different patients groups and could increase effectiveness when the interaction is facilitated by multidisciplinary teams of HCP in comparison to interventions delivered by individual HCP.
DISCUSSION
This systematic review and meta-analysis provide evidence that SDM processes can be an effective strategy to increase influenza vaccination rates. Further research with more detailed descriptions of SDM implementation modalities is necessary to better understand which components of SDM are most effective.
TRIAL REGISTRATION
PROSPERO: CRD42020175555.
Identifiants
pubmed: 33334617
pii: S0264-410X(20)31581-4
doi: 10.1016/j.vaccine.2020.12.014
pii:
doi:
Types de publication
Journal Article
Meta-Analysis
Review
Systematic Review
Langues
eng
Sous-ensembles de citation
IM
Pagination
185-196Informations de copyright
Copyright © 2020 Elsevier Ltd. All rights reserved.
Déclaration de conflit d'intérêts
Declaration of Competing Interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper.