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EHR alerts boost HPV vaccine uptake in young women
A simple reminder via electronic health records significantly increased HPV vaccine initiation and completion among young women, recent data suggest.
“We found that simply alerting patients and providers during an office appointment increased uptake and completion of the HPV vaccine series,” Mack T. Ruffin IV, MD, MPH, professor of family medicine at the University of Michigan Medical School, said in a press release. “Our findings suggest that these prompts through the electronic health system may be a valuable tool in encouraging more people to protect themselves from cancer.”
HPV vaccine coverage has been historically low among young people, with only 37.6% of girls aged 13 to 17 years completing the recommended three-dose series in 2013, according to the CDC. One of several barriers to HPV vaccine uptake reported by parents is not receiving a recommendation for the vaccine from a health care professional.
Mack T. Ruffin
Ruffin and colleagues examined rates of HPV vaccine initiation and completion among female patients aged 9 to 26 years at five Midwest community-based practices between March 2007 and Jan. 25, 2010. The study included 6,019 patients whose clinics had EHR alerts for the vaccine and 9,096 patients without prompts.
The mean age at initiation was 17.3 years in the prompted cohort and 18.1 years in the unprompted cohort.
Study results, published in the Journal of the American Board of Family Medicine, show that more patients in the prompted cohort received at least one dose during the study period compared with the unprompted cohort (35% vs. 21.3%; P < .001). Patients who received prompts also were significantly more likely to receive all three doses on time and with shorter median intervals between each vaccine dose (P < .001), according to the researchers.
Specifically, patients aged 9 to 18 years whose clinics had EHR alerts were almost three times more likely to initiate the HPV vaccine series and 10 times more likely to complete it, while patients aged 19 to 26 years in the prompted cohort were six times more likely to start the vaccine and eight times more likely to complete the series.
“This age demographic often includes a group of patients that typically don’t go to the doctor as often as other groups unless they are ill,” Ruffin said.
In addition, the researchers found that African Americans aged 9 to 18 years with three or more visits during the study period were more likely to initiate the HPV vaccine if their physicians were prompted (P < .001).
Ruffin noted that although HPV vaccine coverage is well below 80% — one of the targets established by the national Healthy People 2020 initiative for adolescents — EHR alerts still show promise in increasing uptake among young women.
“We’re a long way away from achieving the HPV vaccination rates we’d like to see, but our findings potentially identify another valuable step in helping us get closer to our goal,” he said. – by John Schoen
Disclosure: Ruffin is conducting a study funded by the National Cancer Institute. Merck provides free HPV vaccine to the study participants and pays for serum assays.