title: A randomized trial of the effect of centralized reminder/recall on immunizations and preventive care visits for adolescents.
abstract: OBJECTIVE
  To assess the impact of a managed care-based patient reminder/recall system on immunization rates and preventive care visits among low-income adolescents.
  
  
  METHODS
  We conducted a randomized controlled trial between December 2009 and December 2010 that assigned adolescents aged 11-17 years to one of three groups: mailed letter, telephone reminders, or control. Publicly insured youths (n = 4115) were identified in 37 participating primary care practices. The main outcome measures were immunization rates for routine vaccines (meningococcus, pertussis, HPV) and preventive visit rates at study end.
  
  
  RESULTS
  Intervention and control groups were similar at baseline for demographics, immunization rates, and preventive visits. Among adolescents who were behind at the start, immunization rates at study end increased by 21% for mailed (P < .01 vs control), 17% for telephone (P < .05), and 13% for control groups. The proportion of adolescents with a preventive visit (within 12 months) was: mailed (65%; P < .01), telephone (63%; P < .05), and controls (59%). The number needed to treat for an additional fully vaccinated adolescent was 14 for mailed and 25 for telephone reminders; for an additional preventive visit, it was 17 and 29. The intervention cost $18.78 (mailed) or $16.68 (phone) per adolescent per year to deliver. The cost per additional adolescent fully vaccinated was $463.99 for mailed and $714.98 for telephone; the cost per additional adolescent receiving a preventive visit was $324.75 and $487.03.
  
  
  CONCLUSIONS
  Managed care-based mail or telephone reminder/recall improved adolescent immunizations and preventive visits, with modest costs and modest impact.
authors.affiliation: Department of Pediatrics, University of Rochester School of Medicine and Dentistry, Rochester, NY, USA. peter_szilagyi@urmc.rochester.edu
authors.forename: Peter G
authors.initials: PG
authors.lastname: Szilagyi
authors.forename: Christina
authors.initials: C
authors.lastname: Albertin
authors.forename: Sharon G
authors.initials: SG
authors.lastname: Humiston
authors.forename: Cynthia M
authors.initials: CM
authors.lastname: Rand
authors.forename: Stanley
authors.initials: S
authors.lastname: Schaffer
authors.forename: Howard
authors.initials: H
authors.lastname: Brill
authors.forename: Joseph
authors.initials: J
authors.lastname: Stankaitis
authors.forename: Byung-Kwang
authors.initials: BK
authors.lastname: Yoo
authors.forename: Aaron
authors.initials: A
authors.lastname: Blumkin
authors.forename: Shannon
authors.initials: S
authors.lastname: Stokley
mesh_terms: D000293:Adolescent; D016497:Adolescent Health Services / Q000706:statistics & numerical data; D002648:Child; D022681:Diphtheria-Tetanus-acellular Pertussis Vaccines / Q000191:economics / Q000627:therapeutic use; D005260:Female; D006801:Humans; D007114:Immunization / Q000191:economics / Q000706:statistics & numerical data*; D008297:Male; D008329:Managed Care Programs / Q000191:economics; D022401:Meningococcal Vaccines / Q000191:economics / Q000627:therapeutic use; D053918:Papillomavirus Vaccines / Q000191:economics / Q000627:therapeutic use; D011177:Postal Service; D011203:Poverty; D011314:Preventive Health Services / Q000191:economics / Q000706:statistics & numerical data*; D011320:Primary Health Care / Q000191:economics / Q000379:methods*; D017010:Reminder Systems / Q000191:economics; D013689:Telephone
chemical_list: D022681:Diphtheria-Tetanus-acellular Pertussis Vaccines; D022401:Meningococcal Vaccines; D053918:Papillomavirus Vaccines