WASHINGTON The two most commonly used and desired strategies to
immunization in the medical home were prompts to
providers to vaccinate those present and reminders to families to come in for
vaccination, according to the results of a new survey presented here this week.
Sharon Humiston, MD, MPH, of Childrens Mercy Hospitals and
Clinics in Kansas City, Mo., and colleagues from the University of Rochester
Medical Center, N.Y., and the CDC, presented results of a
practitioner survey designed to determine whether
strategies recommended by the CDC to optimize immunization rates were actually
used or were being considered by pediatricians. Although most adolescents
attend a primary care practice, US adolescent immunization rates are low,
according to researchers.
The CDC recommends certain strategies to boost adolescent
immunization. But what we wanted to do was to take a look at what primary care
providers thought about those strategies which ones they were using and
which ones they would use, Humiston said during her presentation at the
45th Annual National Immunization Conference. The total objective of this
study, which goes beyond the survey, is to identify sustainable, generalizable,
effective strategies that can be implemented widely to increase vaccination
coverage among adolescents affiliated with a medical home.
Humiston and colleagues surveyed physicians from two primary care
practice-based research networks: a western New York regional network
consisting of pediatricians and family physicians, and a national network of
pediatric residency training continuity clinics. Practices served patients in
urban (43%), suburban (36%) and rural (21%) locations.
We combined the two networks to have more of a balance between
urban and suburban practices, Humiston said.
The most preferred choice of strategies that were currently used among
the providers included prompts by office staff to the patient during a visit
(24%) and an automated patient reminder system sent to parents (21%). The two
least preferred choices included a prompt to health care provider via
electronic medical record (11%) and having a list of patients in need of
vaccines (1%), such as a list of patients from an insurance company, according
As for choices not currently used but that providers would consider,
prompts to the health care provider via electronic medical record was the top
choice (36%), followed by patient reminder recall (27%). Other evidence-based
strategies (eg, education for the patient or the health care provider, vaccine
clinics, vaccine-only visits, audit and feedback, standing orders) were
selected less frequently.
Based on provider preference, the investigators sent a survey (mailed or
online) about increasing adolescent immunization rates. Participants were asked
about their current use of interventions and strategies they would consider
using in their offices. They received as many as five reminders for the survey
and a $5 gift card as an incentive. For 148 of 195 practices surveyed, the
response rate was 76%, and results from the networks were combined because of
similar results. by Cassandra A. Richards
Disclosure: Dr. Humiston reports no financial disclosures.
Humiston S. #25216. Presented at: the 45th Annual National
Immunization Conference; March 28-31, 2011; Washington, D.C.