Two-minute video boosts pneumonia vaccinations

Americans only receive about half of recommended preventive services, and slightly more than 60 percent of adults 65 and older receive the recommended pneumococcal vaccination.

Part of the reason is primary care physicians and practices lack the time and resources to properly educate patients during short office visits, the authors said. In addition, patients may have limited awareness regarding the need for vaccination.

Individuals who are 65 and older are at increased risk of dying from pneumococcal disease, a serious infection, which can cause pneumonia, meningitis and bloodstream infections (sepsis). Every year, approximately 18,000 adults age 65 and older die from pneumococcal disease in the U.S.

The new approach of pre-visit education has the potential to automatically educate patients about necessary preventive services, providing critical general information linked to upcoming clinic visits. Such a process then allows the limited time during an office visit to be focused on a patient's specific questions and concerns.

The Northwestern study, funded by a grant from the Agency for Healthcare Research and Quality, will be presented May 14 at the 2016 Society of General Internal Medicine Annual Meeting in Hollywood, Florida.

The investigators designed a two-minute video about pneumococcal vaccination, highlighting the need for vaccination across the lifespan. They programmed the electronic health record system to send patients newly eligible for the vaccine a link to an online video a week in advance of the patient's primary care visit.

"This approach demonstrates a new way for patients to receive effective, efficient education about preventive care," said Kenzie A. Cameron, the principal investigator and a research associate professor of medicine at Northwestern University Feinberg School of Medicine.

During a period of about six months, the system sent messages to 116 patients, recommending they view the educational video. Three quarters of patients opened the message. Among those patients, almost 90 percent viewed at least a part of the video and 64 percent watched the entire video. Patients who watched at least part of the video were three times more likely to receive the pneumococcal vaccine.

"It is critical to provide adults who are newly eligible for vaccination accurate information prior to offering the pneumococcal vaccination," Cameron said. Otherwise, patient attitudes, such as preconceived notions about vaccinations and incomplete information may cause individuals to initially refuse the shot, she noted.

"Once patients refuse the shot, health care providers are put in the position of changing someone's response as opposed to shaping an initial response," Cameron said. "It's much more difficult."

As this study primarily was designed to learn if harnessing the power of electronic health records to send patients messages about preventive care was feasible, the next steps will be to test patient vaccination rates in a randomized trial.