Effect of Provider Prompts on Adolescent Immunization Rates: A Randomized Trial

Szilâgyi, Peter G.; Serwint, Janet R.; Humiston, Sharon G.; Rand, Cynthia M.; Schaffer, Stanley J.; Vincelli, Phyllis; Dhepyasuwan, Nui; Blumkin, Aaron; Albertin, Christina; Curtis, C. Robinette

doi:10.1016/j.acap.2014.10.006

Cited by 76 publications

(68 citation statements)

References 26 publications

(36 reference statements)

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“…8,9 Captured opportunities increased after decisions by providers to use consistent language to describe the HPV vaccine, focus on cancer prevention, and emphasize vaccination at acute visits. The project was completed at a modest cost, similar to the cost per clinician of attending a continuing education conference, with the greatest expense the time invested by participating pediatricians.…”

Section: Discussionmentioning

confidence: 99%

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Improving HPV Vaccination Rates Using Maintenance-of-Certification Requirements

Fiks

Luan

Mayne³

2016

Pediatrics

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BACKGROUND: Many pediatricians are now required to participate in American Board of Pediatrics Maintenance of Certification (MOC) Part IV programs focused on improving health care quality, but the benefits of participation are unproven. METHODS: Twenty-seven primary care pediatricians from 11 primary care practices participated in a 1-year MOC program for human papillomavirus (HPV) vaccine. Participants received education and electronic health record (EHR)-generated performance feedback reports with their rates of captured HPV immunization opportunities (dose given at eligible visit) and those of peers. In each of 3 cycles, clinicians collectively identified a goal for improvement. Rates of captured opportunities among adolescents 11 to <18 years old were tabulated, and statistical process control charts were created to evaluate changes over time among participants compared with 200 nonparticipants. Provider perceptions of the program and time invested were recorded via survey. RESULTS: Participating clinicians missed fewer opportunities for HPV vaccination than nonparticipants. MOC participants significantly increased their captured opportunities relative to nonparticipating clinicians by 5.7 percentage points for HPV dose 1 at preventive visits and by 0.7 and 5.6 percentage points for doses 1 and 2, respectively, at acute visits. There were no significant differences for other doses. The estimated program cost was $662/participant. Of the participating pediatricians, 96% felt the effort to participate was warranted, and half would not have joined the project without the MOC requirement. CONCLUSIONS: Participation in MOC Part IV improved vaccination at modest cost and with high pediatrician satisfaction, demonstrating benefits of the program that may help to inform future initiatives.

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Section: Discussionmentioning

confidence: 99%

“…7 Missed opportunities persisted, however, as they have in other studies. 9 These results underscored the need for continued improvement.…”

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confidence: 90%

Improving HPV Vaccination Rates Using Maintenance-of-Certification Requirements

Fiks

Luan

Mayne³

2016

Pediatrics

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“…Electronic health record (EHR) systems can automate reminder-recalls for patients due for HPV vaccination, generate reminder prompts for providers to administer the vaccine, and help facilitate nurse-only immunization visits and walk-in immunization hours that can make completion of the HPV vaccine series easier. Strategies such as reminder-recalls for patients and reminder prompts for providers have often, but not always, been successful at increasing rates of vaccination, 7,8 but implementation of these strategies is inconsistent. In addition, EHRs can generate reports to track the effect of strategies to increase HPV vaccination and potential procedural challenges during implementation (eg, vaccine supply, parents refusing or delaying vaccination, etc).…”

Section: System-level Approachesmentioning

confidence: 99%

Advancing Human Papillomavirus Vaccine Delivery: 12 Priority Research Gaps

Reiter

Gerend

Gilkey

et al. 2018

Academic Pediatrics

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“…27 In addition to the studies described above that combined assessment and feedback with provider reminders, 22,25,27 1 study investigated the effect of provider reminders alone. 29 This study found no effect of electronic health record provider prompts on HPV vaccine initiation or completion in females compared to a standard of care control group.…”

Section: Provider Assessment and Feedback And Provider Remindersmentioning

confidence: 53%