Physicians' Use of Reminder Systems Improves Immunization Rates

October 11, 2000

Although immunization rates for children and adults remain below national goals, a study published in today's Journal of the American Medical Association says primary care providers can increase immunization rates by using a reminder service.

Although experts recommend that providers remind patients of needed immunizations, few do so, says Peter Szilagyi, M.D., lead author of the study and chief of general pediatrics at Children's Hospital at Strong.

Szilagyi and his team set out to assess the effectiveness of patient reminder systems in improving immunization rates, and to compare the effectiveness of different types of reminders for a variety of patient populations. To do this, they reviewed published studies involving patient reminder interventions.

They found that patient reminder systems were effective in improving immunization rates in 33 out of 41 studies, regardless of baseline immunization rates, patient ages, type of setting, or type of vaccination. Depending on the type of reminder used - a phone call letter or postcard, for example - immunization rates increased by between 5 and 20 percent. Phone calls were the most effective way, but also the costliest.

"One of the reasons we did this study is because we understand how important it is to promote interventions that help increase the immunization rate," Szilagyi says. "This study shows us that patient reminder systems in primary care settings are a good way of improving immunization rates, which is a needed preventive measure."

Szilagyi and his fellow physicians believe primary care providers may not perceive the individual studies citing the benefits of reminder studies as benefiting their own practices. That's because some were performed in public health department clinics, or academic teaching hospital clinics.

Another barrier, Szilagyi says, is that primary care practices lack the computerized technology to track their patients' immunization status. However, he points out, recent advances in billing systems and computerized immunization registries are making such technology attainable and affordable for a growing number of primary care practitioners.

"Primary care providers should use patient reminders to make sure more children receive needed immunizations," Szilagyi says. "They work."

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