Impact of Electronic Point-of-Care Prompts on Human Papillomavirus Vaccine Uptake in Retail Clinics

Amanda F Meyer, Nicole L Borkovskiy, Jennifer L Brickley, Rajeev Chaudhry, Andrew Franqueira, Joseph W Furst, Donna M Hinsch, Margaret R McDonah, Jane F Myers, Randi E Petersen, Lila J Finney Rutten, Patrick M Wilson, Robert M Jacobson, Amanda F Meyer, Nicole L Borkovskiy, Jennifer L Brickley, Rajeev Chaudhry, Andrew Franqueira, Joseph W Furst, Donna M Hinsch, Margaret R McDonah, Jane F Myers, Randi E Petersen, Lila J Finney Rutten, Patrick M Wilson, Robert M Jacobson

Abstract

Introduction: Human papillomavirus (HPV) vaccination rates nationally are low. This study determined if an electronic point-of-care prompt in the retail clinic setting increases HPV vaccination rates among an eligible population.

Study design: An interrupted time series assessed change in weekly HPV vaccination rates with the introduction of an electronic point-of-care prompt and rate change in post-intervention period.

Setting/participants: The study sites were two similar retail care clinics in Rochester, Minnesota. Participants were patients who presented to the retail clinics setting between the ages of 9 and 26 years from September 12, 2016, to September 30, 2017.

Intervention: HPV vaccine (nonavalent) was made available at both retail clinics. Staff completed a 2-hour lecture on HPV vaccine and one-on-one training for use of the prompt. Pre- and post-intervention rates of HPV vaccination after initiation of electronic point-of-care prompt were measured. A satisfaction survey was given to all patients or parents/guardians between the ages of 9 and 26 years regardless of HPV vaccine status.

Main outcome measures: HPV vaccination rates per week before and after the introduction of the electronic point-of-care prompt along with satisfaction with HPV vaccine availability and the point-of-care prompt in the retail clinic setting. Data analysis was completed January 2018.

Results: The point-of-care prompt increased the median weekly HPV vaccination rate by 8.6 per 100 patient visits (95% CI=5.8, 11.5, p<0.001). Patients thought it was convenient having HPV vaccine available and helpful to be reminded of the need for HPV vaccine.

Conclusions: This study demonstrates a significant increase of HPV vaccine rates in the retail clinic setting with use of a point-of-care prompt.

Published by Elsevier Inc.

Figures

Figure 1.
Figure 1.
Point-of-care prompt. EPSDT, early periodic screening diagnosis and treatment; BP, blood pressure; OFC, occipital frontal circumference; PHQ-9, Patient Health Questionnaire 9; EMR, electronic medical record; HDL, high-density lipoprotein; LDL, low-density lipoprotein; AME, Ask Mayo Expert; CPM, care process model; HPV, human papillomavirus; Rec., recommended.
Figure 2.
Figure 2.
Weekly rates of HPV vaccine per 100 eligible patients’ pre-prompt and post-prompt. HPV, human papillomavirus.

References

    1. Nordin JD, Solberg LI, Parker ED. Adolescent primary care visit patterns. Ann Fam Med. 2010;8(6):511–516. 10.1370/afm.1188.
    1. Holman DM, Benard V, Roland KB, Watson M, Liddon N, Stokley S. Barriers to human papillomavirus vaccination among U.S. adolescents: a systematic review of the literature. JAMA Pediatr. 2014;168 (1):76–82. 10.1001/jamapediatrics.2013.2752.
    1. Kester L, Zimet G, Fortenberry J, Kahn J, Shew M. A national study of HPV vaccination of adolescent girls: rates, predictors, and reasons for non-vaccination. Matern Child Health J. 2013;17(5):879–885. 10.1007/s10995-012-1066-z.
    1. Sussman A, Dunham L, Snower K, et al. Retail clinic utilization associated with lower total cost of care. Am J Manag Care. 2013;19(4):e148–e157.
    1. Radisic G, Chapman J, Flight I, Wilson C. Factors associated with parents’ attitudes to the HPV vaccination of their adolescent sons: a systematic review. Prev Med. 2017;95:26–37. 10.1016/j.ypmed.2016.11.019.
    1. Cassidy B, Braxter B, Charron-Prochownik D, Schlenk EA. A quality improvement initiative to increase HPV vaccine rates using an educational and reminder strategy with parents of preteen girls. J Pediatr Health Care. 2014;28(2):155–164. 10.1016/j.pedhc.2013.01.002.
    1. Das JK, Salam RA, Arshad A, Lassi ZS, Bhutta ZA. Systematic review and meta-analysis of interventions to improve access and coverage of adolescent immunizations. J Adolesc Health. 2016;59(4 suppl):S40–S48. 10.1016/j.jadohealth.2016.07.005.
    1. Francis DB, Cates JR, Wagner KPG, Zola T, Fitter JE, Coyne-Beasley T. Communication technologies to improve HPV vaccination initiation and completion: a systematic review. Patient Educ Couns. 2017;100(7):1280–1286. 10.1016/j.pec.2017.02.004.
    1. Niccolai LM, Hansen CE. Practice- and community-based interventions to increase human papillomavirus vaccine coverage: a systematic review. JAMA Pediatr. 2015;169(7):686–692. 10.1001/jamapediatrics.2015.0310.
    1. Walling EB, Benzoni N, Dornfeld J, et al. Interventions to improve HPV vaccine uptake: a systematic review. Pediatrics. 2016;138(1): e20153863 10.1542/peds.2015-3863.
    1. Rudavsky R, Pollack CE, Mehrotra A, Rudavsky R, Pollack CE, Mehrotra A. The geographic distribution, ownership, prices, and scope of practice at retail clinics. Ann Intern Med. 2009;151(5):315–320. 10.7326/0003-4819-151-5-200909010-00005.
    1. Rossos K Retail clinics: not just treating illness—preventing it. Pharmacy Times. March 16, 2015. . Accessed June 27, 2018.
    1. Pollack CE, Gidengil C, Mehrotra A. The growth of retail clinics and the medical home: two trends in concert or in conflict? Health Aff (Millwood). 2010;29(5):998–1003. 10.1377/hlthaff.2010.0089.
    1. Minnesota Department of Health. Minnesota Vaccines for Children (MnVFC). . Published 2016. Accessed September 2016.
    1. Vielot NA, Butler AM, Brookhart MA, Becker-Dreps S, Smith JS. Patterns of use of human papillomavirus and other adolescent vaccines in the United States. J Adolesc Health. 2017;61(3):281–287. 10.1016/j.jadohealth.2017.05.016.
    1. Committee Opinion No. 704 Summary: Human Papillomavirus Vaccination. Obstet Gynecol. 2017;129(6):1155–1156. 10.1097/AOG.0000000000002111.
    1. CDC. HPV vaccine information for clinicians. ; Published 2015. Accessed June 27, 2018.
    1. Farias AJ, Savas LS, Fernandez ME, et al. Association of physicians perceived barriers with human papillomavirus vaccination initiation. Prev Med. 2017;105:219–225.10.1016/j.ypmed.2017.07.016.

Source: PubMed

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