HPV Vaccine Reminders at the Point of Service: Efficacy and Missed Opportunities. A Claims Based Study within One Health Plan

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Department of Obstetrics and Gynecology

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Magee, B. Dale; Leung, Katherine G.; Moore Simas, Tiffany A.
Human Papillomavirus; 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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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.