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Evidence summaries

Patient Reminder and Recall Systems to Improve Immunization Rates

Patient reminder and recall systems are effective in improving immunization rates in primary care settings within developed countries. Level of evidence: "A"

A Cochrane review [Abstract] 1 included 75 trials. Different reminders or recalls increase immunization rates compared with no reminder (290 vs 371 per 1000; RR 1.28, 95% CI 1.23 to 1.35; 55 trials, n=138 625) (table T1), Reminders were effective in different childhood, adolescent, and adult vaccinations.

Patient reminder or recall interventions for receipt of immunizations

Intervention type (reminder or recall)Outcome: Received immunizations
Relative effect (95% CI)Assumed risk - No interventionCorresponding risk - Intervention (95% CI)No of participants (studies) Certainty of evidence
Telephone1.75 (1.20 to 2.54)164 per 1000287 per 1000(197 to 417)9 120(7) Moderate
Letter1.29 (1.21 to 1.38)320 per 1000412 per 1000(387 to 442)81 100(27) Moderate
Text message1.29 (1.15 to 1.44)161 per 1000208 per 1000(185 to 232)7 772(6) High
Autodialer message1.17 (1.03 to 1.32)365 per 1000427 per 1000(376 to 482)11 947(5) High
Combination of mail and telephone reminder or recall RR1.28 (1.14 to 1.45)277 per 1000354 per 1000(316 to 402)6 506(8) Moderate
Combination of patient reminder with provider reminder2.91 (2.67 to 3.19)202 per 1000588 per 1000(540 to 644)4 120(2) Moderate

Another Cochrane review [Abstract] 2 assessed the effects of automated telephone communication systems (ATCS) for preventive healthcare. ATCS with interactive voice response (IVR) systems and ATCS with additional functions such as access to an expert to request advice (ATCS Plus) increased immunisation uptake in children (RR 1.25, 95% CI 1.18 to 1.32; 5 studies, n=10 454) and to a lesser extent in adolescents (RR 1.06, 95% CI 1.02 to 1.11; 2 studies, n=5 725).

The following decision support rules contain links to this evidence summary:

    References

    • Jacobson Vann JC, Jacobson RM, Coyne-Beasley T et al. Patient reminder and recall interventions to improve immunization rates. Cochrane Database Syst Rev 2018;(1):CD003941.[PubMed]
    • Posadzki P, Mastellos N, Ryan R et al. Automated telephone communication systems for preventive healthcare and management of long-term conditions. Cochrane Database Syst Rev 2016;(12):CD009921. [PubMed]

Primary/Secondary Keywords