385: Computer-generated reminders influence professional practice

May 28, 2013

PEARLS 385, March 2013, written by Brian R McAvoy.

Clinical Question
How effective are computer-generated reminders delivered on paper to healthcare professionals on professional practice and health care outcomes?

Bottom Line
There was moderate quality evidence that computer-generated reminders delivered on paper to healthcare professionals achieved a moderate (7%) absolute improvement in processes of care. Median improvement in processes of care also differed according to the behaviour the reminder targeted: for instance, reminders to vaccinate improved processes of care by 13.1% (absolute improvement) compared with other targeted behaviours. Reminders to discuss issues with patients were the least effective. Two characteristics emerged as significant predictors of improvement: providing space on the reminder for a response from the clinician, and providing an explanation of the reminder's content or advice. Reminders were not associated with significant improvements in health care outcomes.

Caveat
None of the included studies reported outcomes related to harms or adverse effects of the intervention, such as redundant testing or overdiagnosis.

Context
Healthcare professionals do not always provide care that is recommended or that reflects the latest research, partly because of information overload or inaccessibility. Reminders may help doctors overcome these problems by reminding them about important information or providing advice, in a more accessible and relevant format, at a particularly appropriate time.

Cochrane Systematic Review Arditi C et al. Computer-generated reminders delivered on paper to healthcare professionals: effects on professional practice and health care outcomes. Cochrane Reviews, 2012, Issue 12. Art. No.: CD001175.DOI: 10.1002/14651858. CD001175.pub3. This review contains 32 studies involving over 102,000 participants.

Pearls are an independent product of the Cochrane primary care group and are meant for educational use and not to guide clinical care.