Changing the way doctors practice medicine is difficult, however a new study has shown that combining traditional education with quality improvement and incentives improves Human Papilloma virus (HPV) vaccination rates in boys and girls. The study, which appears on-line in the journal Vaccine, has the potential to produce sustained improvements in these vaccination rates.
Every year, approximately three million Americans seek treatment for HPV related diseases. Twenty-seven thousand Americans develop HPV-related cancer while more than 5,000 people die from this disease. HPV vaccines have the potential to prevent up to 70 percent of cancers caused by the virus, but fewer than half of adolescents have gotten all three required vaccinations.
In this study, researchers from Boston University School of Medicine (BUSM) used a multi-component Performance Improvement Continuing Medical Education (PI CME) intervention approach which consisted of repeated contacts, focused education and individualized feedback with physicians. They also provided the physicians the incentive of completing new medical specialty board certification. The intervention was performed in two federally qualified health centers while six other centers in the same health-care network served as controls. The researchers found that providers were almost twice as likely to vaccinate girls and 10 times more likely to vaccinate boys at intervention compared to control health centers
Recent research emphasizes the importance of providers offering the HPV vaccine at every opportunity, and this study demonstrates the ability of a provider-centered multi-component PI CME intervention to create sustained improvement in HPV vaccination rates. “Right now, too many Americans suffer from HPV-related cancers. These should be considered vaccine-preventable diseases. Physicians have largely eliminated other vaccine-preventable diseases by working hard to vaccinate all their patients–we hope this intervention will help to improve HPV vaccination rates for our young people,” explained corresponding author Rebecca Perkins, MD, MSc, assistant professor of Obstetrics and Gynecology at BUSM and a gynecologist at Boston Medical Center.
The researchers believe that by blending multi-component continuing medical education with routine data collection using electronic medical records, and leveraging requirements for maintaining board certification, this model has the potential for widespread adoption. “National data indicate that many boys and girls are not getting HPV vaccines that they should have to prevent cancer– and lack of provider recommendation is the main reason. We hope to be able to disseminate this education program to other health systems to improve HPV vaccination rates,” she added.
The work of Dr. Perkins, Dr. Hanchate, and Mr. Legler on this study was supported by American Cancer Society Mentored Research Scholar Grant (MRSG-09-151-01).
The Boston University Continuing Medical Education Office, which employs Dr. Zisblatt and Ms. Trucks, received an unrestricted educational grant from Glaxo-Smith-Kline that partially supported this work.