JOURNAL OF THE LOUISIANA STATE MEDICAL SOCIETY
What Louisiana Healthcare Providers Are Saying
Theme Education
Quote
“We start educating parents then on what HPV is. I always give them the statistics on the amount of our the population estimated to already have HPV and not even be aware of it because it is typically asymptomatic so the parents are just very receptive...” (Interview 7) “We do have standing orders and yes it includes HPV vaccinations and all the vaccinations that we give.” (Interview 1) “...we have a pamphlet about how they can sign up for text messaging... we give a reminder call about all of our appointments the day before so we try to remind them to come in and then we send out patient reminders to go through the LINKS system.” (Interview 12) “...we have what is called Televox and what it does is call the home and gives them friendly reminders of their appointment and we usually do it two or three days ahead of the appointment time... Then we have Televox give theman appointment for the next time and we have Televox to remind them of the appointment. So the Televox will call them and let them know that they have an appointment on whatever day it is and there it is located.” (Interview 6) “We would also schedule the next visit at the current visit and that really helps with completion...” (Interview 3) “I let them know that it protects them against the cervical, oral, and anal cancers and that it takes all three (shots)...” (Interview 1)
Standing Orders Reminders
Appointments
Group with Other Vaccines Protects Against Cancer
“...we just grouped into the 11 year old vaccine with tetanus and meningitis vaccine.” (Interview 3)
“We try tomake sure that they are up to date on their wellness visits and when they do come in for their wellness visits their shot records are reviewed as well as when they come in for other office visits.” (Interview 10) “We start offering it when they come in for their 11 year old visits and most of them pretty much say that they will get it but each visit they come in and we see that they don’t have the Gardasil, then we offer it to them again and ask them if they have any questions and have the doctors back us up to try to get them vaccinated...” (Interivew 12) “We go over their shot records pretty much every visit. Whether they come in sick or well or whatever, we try to keep up with them. We have thousands of kids linked here so it’s very difficult. We try to make sure that they are up to date on their wellness visits and when they do come in for their wellness visits, their shot records are reviewed as well as when they come in for other office visits. If we see that they are past due for shots, even if they are sick and can’t give them, we tell then to schedule an appointment in 7-10 days for a recheck and possibly to get their shots.” (Interview 10)
Include in Well Visit as Well as Any Other Visit Make the Recommendation
Make the Recommendation
Table 2. What Louisiana Healthcare Providers are Saying
ACKNOWLEDGEMENTS Supported in part by 1 U54 GM104940 from the National Institute of General Medical Sciences of the National Institutes of Health which funds the LouisianaClinical and Translational Science Center. Supported in part by the Grant or Cooperative Agreement Number, 5 U58 DP003915, funded by the Centers for Disease Control and Prevention. Its contents are solely the responsibility of the authors and do not necessarily represent the official views of the National Institutes of Health, the Centers for Disease Control and Prevention or the Department of Health and Human Services.
7Ways to Improve HPV Vaccination Rates
1. PROVIDER RECOMMENDATION - Advocate for your patients to receive the HPV vaccine. Your recommendation is a large motivating factor. 2. COMBINEWITH OTHER VACCINATION SCHEDULES - Group the HPV vaccination in with the 11 or 12 year old vaccines. 3. SCHEDULE THE NEXT APPOINTMENT DURING THE CURRENTVISIT - Automatically set up the next vaccination visit during the current visit to ensure patients complete the series. 4. PROVIDE REMINDERS - Provide patients with a reminder card when the appointment is made. Follow up with a phone call, postcard, or text message. 5. USE STANDING ORDERS - Make the HPV vaccination a standing order in your clinic for those ages that are eligible to get the vaccine. 6. RECOMMEND AT EVERY CHECK UP - Recommend the HPV vaccination at every well visit or check-up. This provides more than one opportunity to vaccinate and reminds patients that it is important. 7. INSURANCE COVERS IT - Remind your patients that the vaccine is covered by insurance.
REFERENCES
1. HPV and Cancer. Atlanta (GA): Centers for Disease Control and Prevention; 2016. http://www.cdc.gov/cancer/hpv/statistics/cases.htm. Accessed March 15, 2016. 2. Maniscalco L, Lefante C, Hsieh M, Andrews P, Pareti L, Mumphrey B, Ferguson DB, Schmidt B, Li X, Peterson L, O’Flarity M, Lynch, MA, Wu XC (eds). Cancer in Louisiana, 2009-2013. New Orleans: Louisiana Tumor Registry, 2015. (Cancer in Louisiana; Vol. 31.) 3. Saraiya M, Unger ER, Thompson TD, Lynch CF, Hernandez BY, Lyu CW, Steinau M, Watson M, Wilkinson EJ, Hopenhayn C, Copeland G, Cozen W, Peters ES, Huang Y, Saber MS, Altekruse S, Goodman MT; HPV Typing of Cancers Workgroup. US assessment of HPV types in cancers: implications for current and 9-valent HPV vaccines. Journal of the National Cancer Institute 2015;107:djv086. 4. Centers for Disease Control Prevention. FDA licensure of bivalent human papillomavirus vaccine (HPV2, Cervarix) for use in females and updated HPV vaccination recommendations from the Advisory Committee on Immunization Practices (ACIP). MMWR Morb Mortal Wkly Rep. 2010;59(20):626-9. 5. Preventive Services Covered by Private Health Plans under the Affordable Care Act, The Henry J. Kaiser Family Foundation, 2015. http://kff.org/
Figure 2. Seven Way to Improve HPV Vaccination Rates
66 J La State Med Soc VOL 169 MAY/JUNE 2017
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