Systematic review of interventions to increase influenza vaccination rates of those 60 years and older.

A systematic literature review identified 44 RCTs testing interventions to increase influenza vaccination rates among seniors >or=60. Case-control and cohort studies were excluded after review because of problems identifying secular trends and unknown confounders. Because of heterogeneity and unique interventions tested by a single or a few RCTs few studies could be pooled in meta-analysis. Using the CDC classification of interventions: (1) Increasing community demand: there is evidence of low quality that reminders increase influenza vaccination rates; (2) Increasing access: there is evidence of moderate quality that home visits to those >or=60 promoting influenza vaccination increase rates, and (3) Provider- and system-based interventions: there is evidence of moderate quality that facilitators working to improve preventive interventions in practices increase rates. Copyright (c) 2009 Elsevier Ltd. All rights reserved.