Text Messaging Reminders for Influenza Vaccine in Primary Care

Study Overview
=================
Brief Summary
-----------------
Influenza morbidity and mortality cause a substantial financial burden to the NHS and to the UK as a whole. Influenza vaccine is safe and effective but is required annually because the circulating strain of virus changes each year. In the UK in 2012, the Chief Medical Officer (CMO) recommended that at least 75% of elderly people (aged 65+) and 75% people under 65 with certain chronic conditions (e.g. chronic heart disease, diabetes, asthma, etc) should be vaccinated. While primary care practices are achieving these targets for elderly patients, those set for younger patients with chronic conditions are not being met, with a third of patients being missed in the 2011/12 flu season and with no substantial improvements in uptake in the past decade. Therefore strategies to increase flu vaccine uptake in these patients are required. Previous trials have shown that patient reminders can increase vaccine uptake and in particular, text messaging has shown to work in some populations in the United States as a cheap, simple and effective reminder. However, whether the same is true in UK general practice is unclear. The use of text messaging in the NHS for appointment reminders is also increasing as it is cheap, quick and effective. Text messaging is already used in roughly 30% of practices to remind patients about their flu vaccine but there has been no trial addressing its effectiveness. Therefore, we propose a trial of a text messaging flu vaccine reminder in patients aged under 65 who have a chronic condition. We hypothesise that practices that send a text message will have increased flu vaccine uptake.

Official Title
-----------------
A Feasibility Study for a Cluster Randomised Trial of Text Messaging Reminders for Influenza Vaccine in Patients Under 65 in Clinical Risk Groups in English Primary Care.

Conditions
-----------------
Influenza

Intervention / Treatment
-----------------
* Other: Text message influenza vaccination reminder
* Other: Standard care


Participation Criteria
=================
Eligibility Criteria
-----------------
Inclusion Criteria: practices must use text messaging software to communicate with patients; practices must not have used a text message to remind patients aged under 65 about influenza vaccine in the 2012/13 influenza season. practices will send the text message to eligible patients who are aged between 18 and 65, with one of the following risk conditions: chronic respiratory disease, chronic liver disease, chronic kidney disease, chronic heart disease, chronic neurological disease, immunosuppression Exclusion Criteria: practices will not send the text message to pregnant women.

Ages Eligible for Study
-----------------
Minimum Age: 18 Years
Maximum Age: 64 Years

Sexes Eligible for Study
-----------------
All

Accepts Healthy Volunteers
-----------------
No

Study Plan
=================
How is the study designed?
-----------------

Design Details

Allocation: Randomized
Intervention Model: Parallel Assignment
Masking: None (Open Label)


Arms and Interventions

| Participant Group/Arm | Intervention/Treatment |
| --- | --- |
| Other: Standard care<br>Practices in the standard care arm will proceed with their seasonal influenza campaign as planned. | Other: Standard care<br>* Practices in the standard care arm will be asked to proceed with their seasonal influenza campaign as planned.<br>|
| Experimental: Text messaging intervention<br>Practices in the text messaging intervention arm will be asked to send a text message to patients under 65 at risk of influenza. | Other: Text message influenza vaccination reminder<br>* Practices in the text messaging intervention arm will be asked to send a text message to patients under 65 at risk of influenza.<br>|

What is the study measuring?
-----------------
Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Proportion of patients at risk who received flu vaccine |  | up to 9 months | 

Secondary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Proportion of practices reporting 'yes' to difficulties | Proportion of practices reporting 'yes' that they had difficulties in sending the text message to patients | up to 3 months | 
| Recruitment rate | This is a pilot feasibility study and recruitment of practices to the trial is an outcome. | 3 months after initial contact | 
| Practice delivery of text message | Did the practice send the text message to eligible patients and was the content of the message as described in the protocol. | One month after study start (October 1st 2013) | 
| Were outcome data available | Were outcome data regarding text message and flu vaccine uptake available. | up to 9 months | 

 Terms related to the study
=================
Keywords Provided by Centre Hospitalier Valida
-----------------
Text messaging