HPV Vaccine Reminders at the Point of Service: Efficacy and Missed Opportunities. A Claims Based Study within One Health Plan
Magee, B. Dale ; Leung, Katherine G. ; Moore Simas, Tiffany A
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HPV
vaccine
point of service
POS
completion rates
reminders
Gardasil
Cervarix
Community Health and Preventive Medicine
Female Urogenital Diseases and Pregnancy Complications
Health Services Administration
Obstetrics and Gynecology
Public Health Education and Promotion
Women's Health
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Abstract
Introduction: Our objective is to assess HPV vaccine series completion rates, whether on-screen Point of Service reminders (POS) make a difference, and missed opportunities for reminders to have an effect.
Methods: Retrospective, claims-based study of females aged 9-26 receiving an initial dose of HPV vaccine during 2 periods: before (period 1) and after (period 2) implementation of a POS reminder system in 1(“Change Group”) of 2 physician groups using EHRs for both periods. Completion rates, and missed opportunities during eligible periods were calculated for those with continuous enrollment in the health plan investigated.
Results: Completion rates within 1 year of the 1st dose were Period 1: 47% Change Group vs. 46% Control Group (p=0.847). Period 2: 50% Change group vs. 57% Control Group (p=0.158). No significant improvement occurred between the 2 periods in either group. Differences in 1 year completion rates by specialty of initiating provider or age group (≥18) were not significant.
During period 2, among those with continuous insurance plan enrollment in the Change Group, 43 patients received 1 dose and 46 received 2 doses. Of those receiving 1 dose, 30 (70%) had a visit to the same group within an eligible time period (median # visits: 2, range 1-20); of those completing 2 doses, 4 (9%) had a visit to the same group within an eligible period (median # visits: 1, range: 1-3). Among those receiving 1 dose, 25 (58%) had a visit to the same group and same specialty as the initial dose (median # visits: 1, range 1-8); for those having received 2 doses, 3 (6%) had a subsequent visit to same group and specialty (median # visits: 1, range 1-3).
Conclusion: POS reminder systems was not associated with improved completion rates. POS reminders are limited by infrequent visits among non-completers in an eligible period.
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Notes
This is an unpublished manuscript reporting on a study about point of service reminders for the HPV vaccine.