Use of Standing Orders for Vaccination Among Pediatricians

Details

• Alternative Title:
  Pediatrics
• Personal Author:
  Cataldi, Jessica ; O’Leary, Sean T. ; Lindley, Megan C. ; Allison, Mandy A. ; Hurley, Laura P. ; Crane, Lori A. ; Brtnikova, Michaela ; Beaty, Brenda ; McBurney, Erin ; Kempe, Allison
• Description:
  Background:
  
  Standing orders are an effective way to increase vaccination rates, yet little is known about how pediatricians use this strategy for childhood immunizations.
  
  Objective:
  
  We assessed current use of, barriers to using, and factors associated with use of standing orders for vaccination among pediatricians.
  
  Methods:
  
  Internet and mail survey from June-September 2017 among a nationally representative sample of pediatricians. Principal component analysis of barrier items identified two factors: Physician Responsibility and Concerns about Office Processes. Multivariable analysis including barrier scales and physician/practice characteristics was used to identify factors associated with use of standing orders.
  
  Results:
  
  Response rate was 79% (372/471). 59% of respondents reported using standing orders. Most commonly identified barriers among non-users were concern patients may mistakenly receive the wrong vaccine (68%), concern patients prefer to speak with the physician about a vaccine before receiving it (62%), and belief that it is important for the physician to be the person who recommends a vaccine to patients (57%). These three items also made up the Physician Responsibility barrier factor. Respondents with higher Physician Responsibility scores were less likely to use standing orders (RR 0.59, 95% CI: 0.53-0.66 per point increase). System level decision-making about vaccines, suburban/rural location, and lower Concerns about Office Processes score were each associated with use of standing orders in bivariate but not multivariable analysis.
  
  Conclusions:
  
  Among pediatricians, use of standing orders for vaccination is far from universal. Interventions to increase use of standing orders should address physicians’ attitudinal barriers as well as organizational factors.
  
  
• Subjects:
  Adult Female Humans Male Middle Aged Pediatricians Standing Orders Vaccination
• Source:
  Pediatrics. 145(5)
• Pubmed ID:
  32350023
• Pubmed Central ID:
  PMC9955536
• Document Type:
  Journal Article
• Funding:
  CC999999/ImCDC/Intramural CDC HHSUnited States/ ; U01 IP000849/IP/NCIRD CDC HHSUnited States/
• Volume:
  145
• Issue:
  5
• Collection(s):
  CDC Public Access
• Main Document Checksum:
  urn:sha256:30640e93f1b52d4358c52a87ed9fe51576071ea7d9791a9e458e9bc6297ec6da
• Download URL:
  https://stacks.cdc.gov/view/cdc/125111/cdc_125111_DS1.pdf
• File Type:
  [PDF - 194.31 KB ]