Research In Practice Blog
Intro
In 2006, CDC began recommending the human papillomavirus (HPV) vaccine series for eligible adolescents to confer protection against the vast majority of HPV-attributable cancers, including cancers of the mouth, throat, head, neck, and genitals. Since 2006, rates of these cancer-causing HPV infections have dropped significantly. The HPV vaccine series should be administered prior to environmental exposure to the HPV virus, and evidence shows that initiation before age 13 is ideal. However, HPV vaccine rates in this age group remain well below the 80% national target and recently stopped trending upward. Elena Huang, MD, Brian Jenssen, MD, MSHP, and their research colleagues wondered if a broad quality improvement (QI) initiative could help increase HPV vaccine completion by age 13.
The QI Initiative
The 30-practice pediatric primary care network in this study was seeing HPV vaccine series completion by age 13 for only about 30% of patients prior to launching this QI initiative. Practice site characteristics were varied—urban and suburban, teaching and non-teaching, and staffed with anywhere from 3 to 50 providers. Interventions were tailored based on practice needs and included updating clinical decision support tools, establishing additional clinician feedback systems, and adding standing orders. Over the course of 42 months, HPV vaccine completion by age 13 increased to 55%. Additionally, the interventions raised levels of vaccination for patients with public insurance, significantly narrowing the gap between them and patients with private insurance.
Implications
Because this QI initiative was associated with a sizeable, sustained increase in HPV vaccination completion, replication of these efforts at other large primary care network could positively impact HPV vaccination rates in other regions. Similarly, the systems and processes introduced by this QI initiative might also be helpful for healthcare organizations looking to improve rates for other types of vaccines.
Additional information & research related to this topic:
CHOP - A Look at Each Vaccine: Human Papillomavirus and www.Prevent-HPV.org
What Health Systems Can Do Now to Improve Human Papillomavirus Vaccination
Performance Feedback for Human Papillomavirus Vaccination: A Randomized Trial From the American Academy of Pediatrics Pediatric Research in Office Settings Research Network
HPV Vaccinations at Acute Visits and Subsequent Adolescent Preventive Visits
Clinical Futures author(s): Brian P. Jenssen, MD, MSHP