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Provider prompts preferred choice to increase adolescent immunizations
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WASHINGTON — The two most commonly used and desired strategies to increase adolescent immunization in the medical home were prompts to providers to vaccinate those present and reminders to families to come in for vaccination, according to the results of a new survey presented here this week.
Sharon Humiston, MD, MPH, of Children’s Mercy Hospitals and Clinics in Kansas City, Mo., and colleagues from the University of Rochester Medical Center, N.Y., and the CDC, presented results of a practitioner survey designed to determine whether strategies recommended by the CDC to optimize immunization rates were actually used or were being considered by pediatricians. Although most adolescents attend a primary care practice, US adolescent immunization rates are low, according to researchers.
“The CDC recommends certain strategies to boost adolescent immunization. But what we wanted to do was to take a look at what primary care providers thought about those strategies — which ones they were using and which ones they would use,” Humiston said during her presentation at the 45th Annual National Immunization Conference. “The total objective of this study, which goes beyond the survey, is to identify sustainable, generalizable, effective strategies that can be implemented widely to increase vaccination coverage among adolescents affiliated with a medical home.”
Humiston and colleagues surveyed physicians from two primary care practice-based research networks: a western New York regional network consisting of pediatricians and family physicians, and a national network of pediatric residency training continuity clinics. Practices served patients in urban (43%), suburban (36%) and rural (21%) locations.
“We combined the two networks to have more of a balance between urban and suburban practices,” Humiston said.
The most preferred choice of strategies that were currently used among the providers included prompts by office staff to the patient during a visit (24%) and an automated patient reminder system sent to parents (21%). The two least preferred choices included a prompt to health care provider via electronic medical record (11%) and having a list of patients in need of vaccines (1%), such as a list of patients from an insurance company, according to Humiston.
As for choices not currently used but that providers would consider, prompts to the health care provider via electronic medical record was the top choice (36%), followed by patient reminder recall (27%). Other evidence-based strategies (eg, education for the patient or the health care provider, vaccine clinics, vaccine-only visits, audit and feedback, standing orders) were selected less frequently.
Based on provider preference, the investigators sent a survey (mailed or online) about increasing adolescent immunization rates. Participants were asked about their current use of interventions and strategies they would consider using in their offices. They received as many as five reminders for the survey and a $5 gift card as an incentive. For 148 of 195 practices surveyed, the response rate was 76%, and results from the networks were combined because of similar results. – by Cassandra A. Richards
Disclosure: Dr. Humiston reports no financial disclosures.
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