Improving the vaccination status of liver transplant patients: Effectiveness of personally addressing patients and written recommendations to family physicians after 3 years.

backgroundAfter documenting insufficient vaccinations in 444 liver transplant (LT) patients, we investigated the effects of a combined strategy (addressing both patients and primary care physicians) on immunization prevalences after a 3-year follow-up.

methodsThe primary care physicians of all adult LT patients from a university center received a written recommendation addressing immunization needs. Patients were asked for their vaccination documents by phone. Changes in immunization rates for vaccine-preventable diseases after the intervention were calculated based on patients' immunization documents from 2014-2016.

resultsThe study cohort consisted of 401 patients. Prevalence rates for all vaccinations improved during the intervention period compared to the baseline study: tetanus from 88.3% to 92.8%, diphtheria from 80.0% to 89.0%, hepatitis A from 50.1% to 60.8%, hepatitis B from 66.3% to 77.1%, and pneumococci from 62.8% to 76.3%. The influenza vaccination rate improved, but remained at a low level before (2010:13%, 2011:11.5%, 2012:19%) and during the intervention (2014:27.4%, 2015:24.4%, 2016:23.2%). Despite these vaccinations, the prevalence rates of the quality indicators standard vaccinations completed (2013:17.2%; 2016:21.2%), indicated vaccinations completed (2013:2.7%, 2016:4.5%), and all vaccinations completed (2013:1%; 2016 1.5%) improved only slightly.

conclusionsOur results demonstrated that intensified communication by written information to the primary care physician and phone calls to the patients improved the number of vaccinations. Nonetheless, a potential for further improvement persists, especially with regard to annual influenza vaccinations.