Background
Initiation and timely completion of the HPV vaccine in young women is critical. We compared initiation and completion of HPV vaccine among women in two community-based networks with electronic health records: one with a prompt and reminder system (prompted cohort) and one without (unprompted cohort).
Methods
Female patients aged 9–26 years seen between March 1, 2007 and January 25, 2010 were used as retrospective cohorts. Patient demographics and vaccination dates were extracted from the electronic health record.
Results
Patients eligible for the vaccine included 6019 from the prompted cohort and 9096 from the unprompted cohort. Mean age at initiation was 17.3 years in prompted cohort and 18.1 years at unprompted cohort with significantly more (p<0.001) patients initiating in the prompted cohort (34.9%) compared to the unprompted cohort (21.5%). African Americans age 9–18 years with three or more visits during the observation period were significantly more likely to initiate in the prompted cohort (p<0.001). Prompted cohort was significantly more (p<0.001) likely to complete the vaccine series timely compared to unprompted cohort.
Conclusion
More patients age 9–26 years initiated and timely completed the HPV vaccine series in clinics using an electronic health record system with prompts compared to clinics without prompts.
BACKGROUND We wanted to determine whether variations exist in use of a chaperone during the performance of a pelvic examination by family physicians.METHODS A self-administered questionnaire was mailed to 5,000 randomly selected active members of the American Academy of Family Physicians. RESULTS There were 3,551 survey responses (71% response rate) and 2,748 useable questionnaires. Most respondents (75.4%) reported routinely using a chaperone in the room during the collection of a Papanicolaou (Pap) smear. Significantly (P < .00001) more male physicians (84.1%) than female physicians (31.4%) reported using a chaperone. Physicians reporting routine use of a chaperone were significantly younger (P = .01) and did fewer Pap smears per month (P < .00001). Regional reporting of chaperone use varied significantly (P < .00001), with 71.6% reporting use in the Northeast, 89.0% in the South, 65.7% in the Midwest, and 72.4% in the West.CONCLUSION Family physicians vary considerably in the reported use of a chaperone during the collection of a Pap smear. The variation could reflect different regional or local norms, efficiency or resource issues in high-volume clinical settings, or other interpersonal factors. These issues need to be explored in more depth.
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