Effect of physician reminders on preventive care: meta-analysis of randomized clinical trials.
The objective of this study was to assess the clinical value of the physician reminder, an information intervention, in increasing compliance for selected preventive health care measures. Meta-analysis was used to combine the quantitative evidence from randomized controlled clinical trials meeting the eligibility criteria. The trials included in this meta-analysis were conducted in a family or internal medicine clinic. Physician reminders were used in the trials to influence utilization and compliance of preventive health care activities. The use of physician reminders for preventive health care activities resulted in a homogeneous effect for the subcategories of cervical cancer screening (test for heterogeneity X2(2) = 4.122, non-significant) and tetanus immunization (test for heterogeneity X2(2) = 3.139, non-significant). Similarly, the odds ratio from the combination of evidence from the three cervical cancer screening trials was significant (1.180, 95 percent CI: 1.020 to 1.339). The resulting odds ratio from the combination of evidence from the three tetanus immunization trials was significant (2.819, 95 percent CI: 2.664 to 2.975). The results of the meta-analyses for cervical cancer screening and tetanus immunizations indicate that physician reminders are an effective information intervention and can improve compliance for these two preventive health care procedures. Based on the results of this meta-analysis, further trials testing the effect of physician reminders on tetanus immunization would be unnecessary and probably unethical.
Austin
S M
SM
Program in Health Services Management, University of Missouri-Columbia.
Balas
E A
EA
Mitchell
J A
JA
Ewigman
B G
BG
D005260:Female; D006801:Humans; D016017:Odds Ratio; D010349:Patient Compliance; D011314:Preventive Health Services / Q000706:statistics & numerical data*; D016032:Randomized Controlled Trials as Topic; D017010:Reminder Systems; D013745:Tetanus Toxoid; D002583:Uterine Cervical Neoplasms / Q000175:diagnosis
D013745:Tetanus Toxoid