February 16, 2016
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MOC program improves HPV vaccination rates

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An American Board of Pediatrics maintenance of certification program led to improved HPV vaccination rates by participating pediatricians, according to recent findings published in Pediatrics.

“Pediatricians increasingly are requesting evidence of impact to justify the investment of resources in [maintenance of certification (MOC)] activities,” Alexander G. Fiks, MD, MSCE, at The Children’s Hospital of Philadelphia, and colleagues wrote. “The results of this MOC Part IV program demonstrate the potential of this requirement to foster health — in this case the prevention of HPV-related disease, including cancer — through better vaccine coverage.”

The American Board of Pediatrics requires many pediatricians to participate in MOC Part IV programs, which aim to improve health care quality, the researchers wrote. However, the benefits of participation in these programs are unproven.

To determine the benefits of the MOC Part IV programs, Fiks and colleagues enrolled 27 primary care pediatricians from 10 practices to participate in a MOC program from January through November 2013. The program provided a 1-hour webinar about HPV vaccination to each physician, quarterly meetings and performance feedback reports that summarized missed HPV vaccine opportunities for themselves and other study participants. The researchers measured the number of clinician visits during which a patient received a dose of HPV, and compared the change in visits — both preventive and acute visits — for MOC participants vs. 200 nonparticipants. The researchers also surveyed participants about the program’s effectiveness.

For preventive visits, Fiks and colleagues found that MOC participants showed an increase of 5.8 percentage points (95% CI, 3.8-7.7) for HPV dose-1 vaccinations over gains by nonparticipating clinicians. For acute visits, MOC participants increased their vaccination opportunities by 0.7 percentage points (95% CI, 0.1-1.2) for HPV dose 1 and 5.5 percentage points (95% CI, 0.7-10.3) for dose 2 over improvements by nonparticipants. For other doses, there was no significant difference.

The MOC program cost an estimated $662 per participant. Of the 81% of pediatricians who responded to the survey, 96% believed program participation was warranted, and 45% said they would not have participated had the MOC program not offered credit incentive.

“Although improvements were modest and system-level changes may be needed to drive greater improvement, results were achieved at a relatively low cost and with high pediatrician satisfaction,” Fiks and colleagues wrote. “As an increasing number of groups develop MOC programs, leaders and participants should continue to evaluate how this board certification requirement may most meaningfully improve the health of children.” – by Will Offit

Disclosure: The researchers report no relevant financial disclosures.