Improving the Rates of Inpatient Pneumococcal Vaccination: Impact of Standing Orders Versus Computerized Reminders to Physicians

Coyle, Christina M.; Currie, Brian P.

doi:10.1086/502317

Cited by 38 publications

(13 citation statements)

References 27 publications

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“…43 Outcomes All studies reported data on the primary outcome. In inpatient and primary care settings, vaccination rates among eligible patients in the included studies ranged from 42% to 73% with standing orders 32,37 and from 15% to 59.7% with physician reminders, 32,37,39,43 these percentages being much higher compared to rates in control groups who received no intervention, providing evidence that both standing orders protocols and computerized reminders to physicians are effective strategies to increase vaccination rates. 37,39 In emergency department settings computerized reminder system increased vaccination rate from a baseline of 38.8% to 45.4%.…”

Section: New Media Applied To Provider-based Interventions Computerizmentioning

confidence: 91%

“…In particular, we considered seven randomized controlled trials, 26,[31][32][33][34][35][36] five non-randomized trials, 27,30,37-39 three cross-sectional studies, 29,40,41 one case-control study, 42 and three studies that we considered to have an operational research approach. 37,43,44 Studies' sample size ranged from 50 to 9213 subjects (median = 341). One paper described two different studies.…”

Section: Identified Studiesmentioning

confidence: 99%

“…32,37,39 Sample size ranged from 266 37 to 4660 39 subjects. Interventions In the different studies patients eligible for influenza and pneumococcal vaccination were identified and standing orders and physician reminders were activated: semi-manually by querying the clinical information system and by patients' interview, 37 automatically through hospitals' computerized physician order entry systems 32 and integrating 4 different information systems, including the electronic medical record, the computerized triage application, the computerized provider order entry system, and the order tracking application. 43 Outcomes All studies reported data on the primary outcome.…”

Section: New Media Applied To Provider-based Interventions Computerizmentioning

confidence: 99%

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Effectiveness of interventions that apply new media to improve vaccine uptake and vaccine coverage

Odone

Ferrari²,

Spagnoli

et al. 2014

Human Vaccines & Immunotherapeutics

179

121

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Background: Vaccine-preventable diseases (VPD) are still a major cause of morbidity and mortality worldwide. In high and middle-income settings, immunization coverage is relatively high. However, in many countries coverage rates of routinely recommended vaccines are still below the targets established by international and national advisory committees. Progress in the field of communication technology might provide useful tools to enhance immunization strategies.Objective: To systematically collect and summarize the available evidence on the effectiveness of interventions that apply new media to promote vaccination uptake and increase vaccination coverage.Design: We conducted a systematic literature review. studies published from January 1999 to september 2013 were identified by searching electronic resources (Pubmed, embase), manual searches of references and expert consultation.Study setting: We focused on interventions that targeted recommended vaccinations for children, adolescents and adults and: (1) aimed at increasing community demand for immunizations, or (2) were provider-based interventions. We limited the study setting to countries that are members of the Organisation for economic co-operation and Development (OecD). Main outcome measures:The primary outcome was a measure of vaccination (vaccine uptake or vaccine coverage). considered secondary outcomes included willingness to receive immunization, attitudes and perceptions toward vaccination, and perceived helpfulness of the intervention.Results: Nineteen studies were included in the systematic review. The majority of the studies were conducted in the Us (74%, n = 14); 68% (n = 13) of the studies were experimental, the rest having an observational study design. eleven (58%) reported results on the primary outcome. Retrieved studies explored the role of: text messaging (n.7, 37%), smartphone applications (n.1, 5%), Youtube videos (n.1, 5%), Facebook (n.1, 5%), targeted websites and portals (n.4, 21%), software for physicians and health professionals (n.4, 21%), and email communication (n.1, 5%). There is some evidence that text messaging, accessing immunization campaign websites, using patient-held web-based portals and computerized reminders increase immunization coverage rates. Insufficient evidence is available on the use of social networks, email communication and smartphone applications.Conclusion: although there is great potential for improving vaccine uptake and vaccine coverage by implementing programs and interventions that apply new media, scant data are available and further rigorous research-including cost-effectiveness assessments-is needed.

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Section: New Media Applied To Provider-based Interventions Computerizmentioning

confidence: 91%

Section: Identified Studiesmentioning

confidence: 99%

Section: New Media Applied To Provider-based Interventions Computerizmentioning

confidence: 99%

See 1 more Smart Citation

Effectiveness of interventions that apply new media to improve vaccine uptake and vaccine coverage

Odone

Ferrari²,

Spagnoli

et al. 2014

Human Vaccines & Immunotherapeutics

179

121

View full text Add to dashboard Cite

show abstract

“…This idea has been trialed with inhospital vaccination against infl uenza and Streptococcus pneumonia. 27 Our initial strategy did not include opt-out www.hospitalpediatrics.org ordering for vitamin D because our current EMR was unable to correctly identify breastfed infants. Additionally, although an opt-out order may have achieved higher vitamin D prescribing rates, the fact that most infants (63.2%, 810/1281) in our sample did not meet criteria for vitamin D supplementation made opt-in ordering a more suitable initial approach.…”

Section: Discussionmentioning

confidence: 99%

Improved Vitamin D Supplementation in Hospitalized Breastfed Infants Through Electronic Order Modification and Targeted Provider Education

Watnick

Binns

Greenberg

2015

Hospital Pediatrics

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KEY WORDS METHODS:Our urban tertiary care hospital instituted a 2-part intervention: brief education for providers on vitamin D guidelines and insertion of an opt-in order for vitamin D supplements into electronic admission order sets. Data downloads on admissions of patients aged <1 year were obtained. We excluded those not breastfed, with a dietary restriction, or admitted to intensive care. Intervention effects were compared from 6 months postintervention to the 6 same months 1 year earlier. We applied χ 2 and logistic regression, including the patient as a random effect to adjust for repeated admissions. RESULTS:Data on 471 exclusively or partially breastfed admissions (441 infants) were analyzed (221 preintervention, 250 postintervention). Admission characteristics did not differ by period: 55.0% boys; 40.6% Medicaid; 63.7% hospitalized ≤2 days; 72.0% on a general medical service; 16.6% received nutritionist consultation. In-hospital vitamin D prescribing rates signifi cantly increased postintervention (19.5% vs 44.4%; P < .001). Postintervention admissions were more than twice as likely to receive vitamin D supplementation (adjusted odds ratio 2.3, 95% confi dence interval 1.6-3.2). Other associated factors included vitamin D as a medication used before admission (adjusted odds ratio 14.3, 95% confi dence interval 4.9-41.6), nutritionist consultation during admission, hospitalization ≥3 days, and admission to a general medical service. Prescribing of vitamin D at discharge increased signifi cantly (9.0% vs 19.6%; P < .001). CONCLUSIONS:Medical provider education and modifi cation of electronic ordering templates signifi cantly increased use of vitamin D supplementation in hospitalized breastfed infants.

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“…Dexter et al [40] found the vaccination rate for standing orders (51%) significantly higher when compared with the rate for computer generated physician reminders (31%). Coyle et al [41] also found the standing order rate (98%) to be significantly higher than the computerized physician reminder rate (23%) suggesting the need for further research to identify the circumstances where each intervention or combination of interventions is most effective. While the implementation of standing orders is, relatively speaking, a straightforward intervention, the implementation of a clinical reminder system is more complex and its successful implementation/use are more affected by nuances of the specific implementation [42][43][44].…”

Section: The Experience Of the Veterans Healthcare Administrationmentioning

confidence: 99%

Strategies for improving pneumococcal vaccination in eligible patients

Smith¹,

Craig²

2006

Curr Infect Dis Rep

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Despite the fact that invasive Streptococcus pneumoniae remains a leading cause of death, current levels of immunization in the at risk population remain low and well below the 90% goal for Healthy People 2010. A number of intervention strategies to increase immunization rates (for influenza and pneumonia) have been demonstrated to be effective in increasing these rates when used alone or in combination. A summary of this literature is presented including recent data on the effectiveness of pay-for-performance approaches for increasing preventive care. Data are also presented on intervention strategies judged to be most effective in a large health care system, the Veterans Health Administration, which has essentially reached the Healthy People 2010 goal for pneumococcal immunization.

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Improving the Rates of Inpatient Pneumococcal Vaccination: Impact of Standing Orders Versus Computerized Reminders to Physicians

Abstract: Although both interventions were effective in increasing inpatient pneumococcal vaccination rates relative to baseline practice, physician independent initiation of standing orders was clearly more effective.

Cited by 38 publications

References 27 publications

Effectiveness of interventions that apply new media to improve vaccine uptake and vaccine coverage

Effectiveness of interventions that apply new media to improve vaccine uptake and vaccine coverage

Improved Vitamin D Supplementation in Hospitalized Breastfed Infants Through Electronic Order Modification and Targeted Provider Education

Strategies for improving pneumococcal vaccination in eligible patients

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