Impact of a clinical interventions bundle on uptake of HPV vaccine at an OB/GYN clinic.

Abstract:

INTRODUCTION:HPV vaccine uptake is lowest among young adults. Little is known about the most effective way to decrease missed opportunities (MO) and increase uptake of the vaccine in this vulnerable population. OBJECTIVES:To determine the impact of a clinical intervention bundle on the rate of MO and uptake of the vaccine among young adult women. METHODS:From 2/2014 to 7/2015, an intervention bundle (designating physician and nurse champions, pre-screening patients' charts, empowering nurses to recommend immunization, providing no-cost vaccinations, placing prompts in clinic note templates, eliminating requirement for pre-vaccination pregnancy test) was implemented at an urban, hospital-based OB/GYN clinic. Medical records were reviewed for all vaccine-eligible (non-pregnant, 11-26 years) women seen between 2/2013 and 9/2016. Impact of the bundled interventions on the monthly rates of MO and vaccine uptake was estimated by analyzing immunization trends with an interrupted time-series model using counterfactual comparison groups in order to control for pre-existing trends. RESULTS:There were 6,463 vaccine-eligible visits during our study period. The prevalence of women who had both completed and initiated the series was significantly higher, 20.3% and 29.7% respectively, in the last month, compared to their counterfactuals (p < 0.01). In the last study month, the rate of MO was significantly lower than its counterfactual (19.73 per 100 encounters lower, p < 0.01). Hispanic women had attributable reductions in their rates of MO that were twice that of White women. Statistically significant attributable reductions were also seen among Spanish speakers, publicly insured, and uninsured women. CONCLUSIONS:Implementation of this intervention bundle effectively reduced the monthly rate of MO and increased the prevalence of women who had initiated and completed the HPV vaccine series. The reduction of MO was most drastic among Hispanic, publicly insured and uninsured women compared to White and privately insured.

journal_name

Vaccine

journal_title

Vaccine

authors

Deshmukh U,Oliveira CR,Griggs S,Coleman E,Avni-Singer L,Pathy S,Shapiro ED,Sheth SS

doi

10.1016/j.vaccine.2018.05.039

subject

Has Abstract

pub_date

2018-06-14 00:00:00

pages

3599-3605

issue

25

eissn

0264-410X

issn

1873-2518

pii

S0264-410X(18)30659-5

journal_volume

36

pub_type

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