Impact of an electronic medical record reminder on hepatitis B vaccine initiation and completion rates among insured adults with diabetes mellitus

Hechter, Rulin C.; Qian, Lei; Luo, Yi; Grant, Deborah S. Ling; Baxter, Roger; Klein, Nicola P.; Nunley, Karen Valdez; Aukes, Laurie; Hogea, Cosmina; Krishnarajah, Girishanthy; Patterson, Brandon J.; Im, Theresa M; Tseng, Hung Fu

doi:10.1016/j.vaccine.2018.06.035

Cited by 21 publications

(21 citation statements)

References 6 publications

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“…30 More recent analyses 31,32 compared 3-dose HepB vaccine completion rates in patients with diabetes aged 19-59 years between two large US managed care organizations, Kaiser Permanente Southern California in which an electronic alert and a reminder were implemented in the EMR and Kaiser Permanente Northern California in which no such reminder was used. 31 The site with EMR reminders increased vaccination coverage rapidly from 7.6% in 2012 to 29.4% in 2015, while no increase was seen at the site with no EMR reminder. 31,32 EMR are increasingly being adopted by health systems, 31 and might therefore be a valuable tool for improving vaccination completion.…”

Section: Commercial/medicare Medicaidmentioning

confidence: 92%

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Hepatitis A, B, and A/B vaccination series completion among US adults: A claims-based analysis

Ghaswalla

Patterson

Cheng

et al. 2018

Human Vaccines & Immunotherapeutics

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Hepatitis A and B disease burden persists in the US. We assessed hepatitis A and hepatitis B vaccination series completion rates among 350,240 commercial/Medicare and 12,599 Medicaid enrollees aged ≥19 years. A vaccination series was considered as completed provided that the minimum interval between doses, as defined by the CDC, and the minimum number of doses were reached. We stratified completion rates by vaccine type (i.e. monovalent or bivalent) at initial vaccination for each cohort. In the commercial/Medicare cohort, the series completion rate was 32.0% for hepatitis A and 39.6% for hepatitis B among those who initiated with a monovalent vaccine, and it was 36.2% for hepatitis A and 48.9% for hepatitis B among those who initiated with a bivalent vaccine. In the Medicaid cohort, the series completion rate was 21.0% for hepatitis A and 24.0% for hepatitis B among those who initiated with a monovalent vaccine, and it was 19.0% for hepatitis A and 24.6% for hepatitis B among those who initiated with a bivalent vaccine. In conclusion, hepatitis A and B vaccination series completion rates were low, and appeared to be lower among Medicaid than among commercial/Medicare enrollees. Commercial/Medicare enrollees who initiated with a bivalent vaccine had higher series completion rates than those who initiated with monovalent vaccines - an observation that was not made among Medicaid enrollees.

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Section: Commercial/medicare Medicaidmentioning

confidence: 92%

“…31 The site with EMR reminders increased vaccination coverage rapidly from 7.6% in 2012 to 29.4% in 2015, while no increase was seen at the site with no EMR reminder. 31,32 EMR are increasingly being adopted by health systems, 31 and might therefore be a valuable tool for improving vaccination completion.…”

Section: Commercial/medicare Medicaidmentioning

confidence: 92%

Hepatitis A, B, and A/B vaccination series completion among US adults: A claims-based analysis

Ghaswalla

Patterson

Cheng

et al. 2018

Human Vaccines & Immunotherapeutics

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“…The median time to vaccination results underscore the importance of increasing awareness among providers of ACIP recommendations for vaccinating adults at increased risk for hepatitis A or B infection. The effectiveness of electronic medical record (EMR) reminders in increasing the uptake of hepatitis B vaccination among patients with diabetes has been demonstrated previously, (Hechter et al, 2019) and these results warrant further research to determine if median time to initial vaccination after initial diagnosis of an ACIP recommended condition could be decreased through effective interventions.…”

Section: Discussionmentioning

confidence: 78%

The role of provider characteristics on the hepatitis A and B vaccination status of adults in the United States during 2007–2015

Ghaswalla

Patterson

Cheng

et al. 2019

Preventive Medicine Reports

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Hepatitis A and B vaccine coverage is suboptimal in US adults, even among those at increased risk for infection, morbidity, or mortality. To understand where medical education and resources might enhance vaccine coverage, it is important to first identify providers and places most commonly associated with the administration of hepatitis vaccinations. We conducted a retrospective analysis of commercial and Medicare insurance claims data from 2007 to 2015 to describe provider types and places of vaccination against hepatitis A and B among adults in the US, and estimated the time to initial vaccination from first diagnosis of a condition for which the Advisory Committee on Immunization Practices (ACIP) recommends hepatitis A and/or B vaccination among at-risk adults. We identified 183,326 adults who received hepatitis A vaccine, 148,119 hepatitis B vaccine, and 64,953 a bivalent vaccine. Mean age was 42.1–45.8 years. Family practice and internal medicine physicians were the main vaccine providers: 38.9% and 20.2% for hepatitis A, 43.7% and 21.4% for hepatitis B, 35.3% and 15.9% for bivalent vaccinations, respectively. ≥90% of initial vaccinations occurred in an office practice. In at-risk patients, median time to first-dose received was 11.8, 20.9, and 20.9 months for hepatitis A, hepatitis B, and hepatitis A/B vaccines, respectively. Primary care and office practices were the most common providers and places of vaccination, respectively, for hepatitis A and B vaccine. For at-risk patients, further research is needed to design vaccination strategies to improve the median time from first ACIP-recommended condition diagnosis to initial vaccination against hepatitis A and B.

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“…Discussion of influenza vaccination in patient groups during hospital staff meetings or the establishment of registers of children with SMRC and use of messaging software, currently used for appointment reminders, could assist in improving uptake. Alternatively, structural remedies at the practice level incorporating the use of electronic medical record systems that continue to prompt at each visit and encourage an ongoing conversation have demonstrated effectiveness . Nationally, increasing the capability of the Australian Immunisation Register to capture risk status could provide another mechanism for recommendations to reach parents and help establish accurate coverage information for this priority target group, which is missing on a large scale globally…”

Section: Discussionmentioning

confidence: 99%

Seasonal influenza vaccination for children with special risk medical conditions: Does policy meet practice?

Tuckerman

Crawford

Marshall

2020

J Paediatrics Child Health

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Aim Ensuring children with special risk medical conditions (SRMC) are protected from influenza is important. The study objective was to describe influenza vaccination practices of medical professionals caring for children with SRMC and explore characteristics associated with a vaccine recommendation. Methods Design: Cross‐sectional survey. Setting/Participants: Treating paediatric specialists and general practitioners of children with confirmed SRMCs. Postal questionnaire administered from March to September 2018 (option for online response). Characteristics associated with providing a recommendation were explored using univariable and multivariable analyses. Results Overall response rate of 24.8% with the sample representative of the eligible population in terms of practice location and years practicing medicine. There was a higher response from females and sub‐specialists. Of the 198 completed survey responders, 97.8% were aware of the recommendation, yet only 38.4% reported they ‘always’ routinely recommended influenza vaccine and fewer (19.5%) were very confident in understanding all ‘medically at risk’ conditions. Medical professionals were more likely to provide a recommendation always or mostly, if they received annual influenza vaccination themselves (adjusted odds ratio (aOR) 3.96, confidence interval (CI) 1.12–14.03), had confidence in understanding all ‘medically at risk’ conditions (aOR 1.82, CI 1.04–3.17) and perceived ownership of the responsibility to provide the recommendation (aOR 7.35, CI 1.67–32.26). Regional practising medical professionals were less likely to provide a recommendation (aOR 0.25 CI 0.10–0.70). Conclusions We need to improve medical professionals' knowledge through reminders and access to consistent and concise information about what constitutes a SRMC. Increasing medical professionals' engagement in the influenza vaccination programme could also provide a sense of responsibility fostering provider endorsement.

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Impact of an electronic medical record reminder on hepatitis B vaccine initiation and completion rates among insured adults with diabetes mellitus

Cited by 21 publications

References 6 publications

Hepatitis A, B, and A/B vaccination series completion among US adults: A claims-based analysis

Hepatitis A, B, and A/B vaccination series completion among US adults: A claims-based analysis

The role of provider characteristics on the hepatitis A and B vaccination status of adults in the United States during 2007–2015

Seasonal influenza vaccination for children with special risk medical conditions: Does policy meet practice?

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