1. IMPROVING THE COMMUNICATION ABOUT THE VACCINATION AND THE AVAILABILITY TOWARDS VACCINAL CAMPAIGNS AGAINST INFLUENZA IN THE ELDERLY : A LOCAL PROJECT IN PRIMARY HEALTH CARE IN NORTH EAST ITALY Filippo de Nicolellis, MD Primary Health Care, AAS 2 “Bassa Friulana - Isontina” Atlanta, GA, USA, December 9 th, 2015

2. THE COMMUNICATION AND THE ORGANIZATION OF THE VACCINATION AGAINST INFLUENZA IN A RURAL AREA OF FRIULI VENEZIA GIULIA IN THE FIELD OF PRIMARY HEALTH CARE: AN EXPERIENCE Atlanta, GA, USA, December 9 th, 2015

3. A LOCAL E-NETWORK TO KEEP DOCTORS INFORMED WHY A LOCAL E-NETWORK DEALING WITH MEDICAL INFORMATION ABOUT INFECTIOUS DISEASES? Atlanta, GA, USA, December 9 th, 2015

4. At the time of SARS contagion, it emerged the need to improve the information provided by the Public Health Service. Some of the doctors operating in the territory, especially in rural areas, have decided to use the Internet to rapidly exchange information about possible clinical cases in the area. Atlanta, GA, USA, December 9 th, 2015

5. “SARS” DISPATCH At the moment, the “SARS” Dispatch is being addressed to 106 doctors out of 1,300 around all the area. Atlanta, GA, USA, December 9 th, 2015

6. AIM OF THE PROJECT To optimize the number of vaccinated people in a specific area of Bassa Friulana. This aim is still complex in a country where family doctors do not have an organized structure and rather perform a work still based on the principle of expectancy, with a limited space for initiative. Atlanta, GA, USA, December 9 th, 2015

7. The vaccination against influenza is free and voluntary for: 1) patients over 65 years old 2) all the people involved in essential services 3) people suffering from serious pathologies Atlanta, GA, USA, December 9 th, 2015

8. In the Fall of 2014, in Italy it occurred a press campaign, after some deaths among elder people. They had been vaccinated against influenza one or two days before. The rate of vaccinated patients felt in Friuli Venezia Giulia compared to the other regions of Italy. Atlanta, GA, USA, December 9 th, 2015

9. ORGANIZATION AND PROMOTION OF VACCINATION FOR PATIENTS I prearranged the communication via e-mail to the interested patients to: 1) improve the quality of the information about characteristics, dates and methods 2) increase the number over-65-year-old patients who agree on taking the vaccination 3) have enough available vaccine to meet the requests of patients. Atlanta, GA, USA, December 9 th, 2015

10. METHODS TO IMPROVE THE QUALITY OF THE INFORMATION PROVIDED TO PATIENTS 1) COMMON METHODS A) posters and leaflets provided by primary care trusts. B) information papers reporting the dates of vaccination sessions in my office. Atlanta, GA, USA, December 9 th, 2015

11. INNOVATIVE METHODS E-mail communications sent to 378 out of 1,425 patients of my office who are provided with an Internet connection. Three e-mails have been sent: 1) “advance notice” e-mails, a month before the effective beginning of the vaccination campaign 2) e-mails confirming the beginning of the campaign, including the dates of the first sessions (six sessions during the month of November) 3) e-mails reporting about later dates and including information about the end of the vaccination session within the 22 nd of December (four to six further available dates). Atlanta, GA, USA, December 9 th, 2015

12. METHODS I started as a family doctor, expert in Infectious Diseases, and as the president of the local medical and cultural association,“CROCE MEDICA”, so I deal with two aspects: 1) THE PATIENTS (with communication and information about the vaccinations available in my office). 2) THE COLLEGUES (with information about the vaccination against Influenza, updates on its forms, and other infectious diseases related to the activity of family doctors). Atlanta, GA, USA, December 9 th, 2015

13. TO INCREASE THE SPREAD OF VACCINATION The e-mails remind patients about the vaccination dates as well as they promote a new way to contact the family doctor and to receive more information about the vaccination. The information by e-mails has also facilitated the patients’ self-organization. Atlanta, GA, USA, December 9 th, 2015

14. TO HAVE ENOUGH AVAILABLE VACCINE 1) Personally reserving the vaccine dose in the doctor’s office. 2) Constantly having the situation under control. 3) Asking for the vaccine doses realistically corresponding to the patients requests. 4) Being able to guarantee vaccination to all the entitled people. 5) Reducing wastefulness. Atlanta, GA, USA, December 9 th, 2015

15. A LOCAL NETWORK TO KEEP DOCTORS INFORMED The Association CROCE MEDICA, along with S.M.I., (The Italian Union of Doctors) took the initiative to issue an on-line dispatch called “SARS” sent to 106 doctors. The dispatch, besides influenza virus, is sometimes about other epidemic diseases which might concern also Friuli Venezia Giulia, such as West Nile virus, Chikungunya virus, Metapneumovirus and, recently, Ebola virus. Atlanta, GA, USA, December 9 th, 2015

16. THE INFORMATION FEEDBACK Unfortunately, the information feedback is still scarce and it is limited to an average of 4 out of 106 doctors, who send information in relation to each yearly issue. Atlanta, GA, USA, December 9 th, 2015

17. OUTCOME There has been a small increase in the participation in the vaccination campaign against influenza in the last years. This outcome may be interpreted in several ways… According to the improvement of communication? Atlanta, GA, USA, December 9 th, 2015

18. VACCINATION CAMPAIGN 2012-2013 VACCINATED PEOPLE OVER 65 YEARS OLD = 55,7% (LOCAL RATE) VACCINATION CAMPAIGN 2013-2014 VACCINATED PEOPLE OVER 65 YEARS OLD= 56% (LOCAL RATE) AND… VACCINATION CAMPAIGN 2014-2015 VACCINATED PEOPLE OVER 65 YEARS OLD= 53,9 (LOCAL RATE, while the press campaign was running...) Atlanta, GA, USA, December 9 th, 2015

19. BUT…. VACCINATION CAMPAIGN 2014-2015 REGIONAL RATE= 48% Atlanta, GA, USA, December 9 th, 2015