Prompting Clinicians about Preventive Care Measures: A Systematic Review of Randomized Controlled Trials

• Published in: Journal of the American Medical Informatics Association : JAMIA Vol. 15; no. 3; pp. 311 - 320
• Main Authors: Dexheimer, Judith W., Talbot, Thomas R., Sanders, David L., Rosenbloom, S. Trent, Aronsky, Dominik
• Format: Journal Article
• Language: English
• Published: England Elsevier Inc 01.05.2008; American Medical Informatics Association
• Subjects: Humans; Practice Patterns, Physicians' - statistics & numerical data; Preventive Health Services - utilization; Preventive Medicine - standards; Quality Assurance, Health Care; Randomized Controlled Trials as Topic; Reminder Systems; Review Paper
• ISSN: 1067-5027; 1527-974X
• DOI: 10.1197/jamia.M2555

Preventive care measures remain underutilized despite recommendations to increase their use. The objective of this review was to examine the characteristics, types, and effects of paper- and computer-based interventions for preventive care measures. The study provides an update to a previous systematic review. We included randomized controlled trials that implemented a physician reminder and measured the effects on the frequency of providing preventive care. Of the 1,535 articles identified, 28 met inclusion criteria and were combined with the 33 studies from the previous review. The studies involved 264 preventive care interventions, 4,638 clinicians and 144,605 patients. Implementation strategies included combined paper-based with computer generated reminders in 34 studies (56%), paper-based reminders in 19 studies (31%), and fully computerized reminders in 8 studies (13%). The average increase for the three strategies in delivering preventive care measures ranged between 12% and 14%. Cardiac care and smoking cessation reminders were most effective. Computer-generated prompts were the most commonly implemented reminders. Clinician reminders are a successful approach for increasing the rates of delivering preventive care; however, their effectiveness remains modest. Despite increased implementation of electronic health records, randomized controlled trials evaluating computerized reminder systems are infrequent.