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Randomized controlled trial of centralized vaccine reminder/recall to improve adult vaccination rates in an accountable care organization setting.
Prev Med Rep. 2019 Sep; 15:100893.PM

Abstract

Our objectives were to assess 1) effectiveness of using Colorado's Immunization Information System (CIIS) to send out vaccine reminder/recalls (R/Rs) centrally vs. usual care for adult vaccine delivery within an accountable care organization (ACO) and 2) practice staff's perception of centralized R/R. From 9/2016 to 4/2017, we conducted a randomized controlled trial among adults enrolled in a Medicaid ACO at six healthcare entities. Adults were divided into two strata: 15,153 age 19-64 and 616 age 65+. Adults age 19-64 who needed influenza and/or Tdap vaccine, and adults age 65+ who needed influenza, and/or Tdap, and/or a pneumococcal vaccine were randomized to receive up to 3 R/Rs by autodialed telephone and mail or usual care. Documentation of receipt of any needed vaccines in CIIS within six months was the primary outcome. We assessed intervention effectiveness using mixed effect logistic regression. Thirteen semi-structured exit interviews were conducted with staff from each healthcare entity. The intervention was not associated with the primary outcome for the age 19-64 population [OR 1.06 (95% CI 0.98-1.15)] or age 65+ population [(OR 0.96 (0.69-1.32)]. Practice staff perceived the intervention to be beneficial and not burdensome. Perceived barriers included lack of availability of appointments and adults receiving only influenza vaccine when other vaccines were needed. In conclusion, centralized R/R was not effective at improving adult vaccination rates in a Medicaid ACO. Future studies should consider better harmonizing vaccine centralized R/Rs with vaccine delivery efforts within the practice setting. Clinical Trials Registration Number: NCT02133391.

Authors+Show Affiliations

Adult and Child Consortium for Health Outcomes Research and Delivery Science, University of Colorado School of Medicine and Childrens Hospital Colorado, Aurora, CO, United States of America. Division of General Internal Medicine, Denver Health, Denver, CO, United States of America.Adult and Child Consortium for Health Outcomes Research and Delivery Science, University of Colorado School of Medicine and Childrens Hospital Colorado, Aurora, CO, United States of America. Department of Biostatistics, Colorado School of Public Health, Aurora, CO, United States of America.Adult and Child Consortium for Health Outcomes Research and Delivery Science, University of Colorado School of Medicine and Childrens Hospital Colorado, Aurora, CO, United States of America.Adult and Child Consortium for Health Outcomes Research and Delivery Science, University of Colorado School of Medicine and Childrens Hospital Colorado, Aurora, CO, United States of America.Adult and Child Consortium for Health Outcomes Research and Delivery Science, University of Colorado School of Medicine and Childrens Hospital Colorado, Aurora, CO, United States of America. Department of Family Medicine, University of Colorado School of Medicine, Aurora, CO, United States of America.Colorado Department of Public Health and Environment, Denver, CO, United States of America.Adult and Child Consortium for Health Outcomes Research and Delivery Science, University of Colorado School of Medicine and Childrens Hospital Colorado, Aurora, CO, United States of America. Department of Pediatrics, University of Colorado School of Medicine, Aurora, CO, United States of America.

Pub Type(s)

Journal Article

Language

eng

PubMed ID

31193580

Citation

Hurley, Laura P., et al. "Randomized Controlled Trial of Centralized Vaccine Reminder/recall to Improve Adult Vaccination Rates in an Accountable Care Organization Setting." Preventive Medicine Reports, vol. 15, 2019, p. 100893.
Hurley LP, Beaty B, Lockhart S, et al. Randomized controlled trial of centralized vaccine reminder/recall to improve adult vaccination rates in an accountable care organization setting. Prev Med Rep. 2019;15:100893.
Hurley, L. P., Beaty, B., Lockhart, S., Gurfinkel, D., Dickinson, L. M., Roth, H., & Kempe, A. (2019). Randomized controlled trial of centralized vaccine reminder/recall to improve adult vaccination rates in an accountable care organization setting. Preventive Medicine Reports, 15, 100893. https://doi.org/10.1016/j.pmedr.2019.100893
Hurley LP, et al. Randomized Controlled Trial of Centralized Vaccine Reminder/recall to Improve Adult Vaccination Rates in an Accountable Care Organization Setting. Prev Med Rep. 2019;15:100893. PubMed PMID: 31193580.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Randomized controlled trial of centralized vaccine reminder/recall to improve adult vaccination rates in an accountable care organization setting. AU - Hurley,Laura P, AU - Beaty,Brenda, AU - Lockhart,Steven, AU - Gurfinkel,Dennis, AU - Dickinson,L Miriam, AU - Roth,Heather, AU - Kempe,Allison, Y1 - 2019/05/22/ PY - 2018/11/18/received PY - 2019/05/06/revised PY - 2019/05/12/accepted PY - 2019/6/14/entrez PY - 2019/6/14/pubmed PY - 2019/6/14/medline KW - Accountable care organization KW - Adult KW - Clinical trial KW - Influenza vaccines KW - Pertussis vaccine KW - Pneumococcal vaccines KW - Vaccination SP - 100893 EP - 100893 JF - Preventive medicine reports JO - Prev Med Rep VL - 15 N2 - Our objectives were to assess 1) effectiveness of using Colorado's Immunization Information System (CIIS) to send out vaccine reminder/recalls (R/Rs) centrally vs. usual care for adult vaccine delivery within an accountable care organization (ACO) and 2) practice staff's perception of centralized R/R. From 9/2016 to 4/2017, we conducted a randomized controlled trial among adults enrolled in a Medicaid ACO at six healthcare entities. Adults were divided into two strata: 15,153 age 19-64 and 616 age 65+. Adults age 19-64 who needed influenza and/or Tdap vaccine, and adults age 65+ who needed influenza, and/or Tdap, and/or a pneumococcal vaccine were randomized to receive up to 3 R/Rs by autodialed telephone and mail or usual care. Documentation of receipt of any needed vaccines in CIIS within six months was the primary outcome. We assessed intervention effectiveness using mixed effect logistic regression. Thirteen semi-structured exit interviews were conducted with staff from each healthcare entity. The intervention was not associated with the primary outcome for the age 19-64 population [OR 1.06 (95% CI 0.98-1.15)] or age 65+ population [(OR 0.96 (0.69-1.32)]. Practice staff perceived the intervention to be beneficial and not burdensome. Perceived barriers included lack of availability of appointments and adults receiving only influenza vaccine when other vaccines were needed. In conclusion, centralized R/R was not effective at improving adult vaccination rates in a Medicaid ACO. Future studies should consider better harmonizing vaccine centralized R/Rs with vaccine delivery efforts within the practice setting. Clinical Trials Registration Number: NCT02133391. SN - 2211-3355 UR - https://www.unboundmedicine.com/medline/citation/31193580/Randomized_controlled_trial_of_centralized_vaccine_reminder/recall_to_improve_adult_vaccination_rates_in_an_accountable_care_organization_setting_ L2 - https://linkinghub.elsevier.com/retrieve/pii/S2211-3355(19)30072-5 DB - PRIME DP - Unbound Medicine ER -
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