Improving preventive care by prompting physicians

E. Andrew Balas, Scott Weingarten, Candace T. Garb, David Blumenthal, Suzanne Austin Boren, Gordon D. Brown

Research output: Contribution to journalArticle

293 Citations (Scopus)

Abstract

Objectives: To assess the impact of prompting physicians on health maintenance, answer questions regarding the mode of delivery, and identify opportunities and limitations of this information intervention. Methods: Systematic electronic and manual searches (January 1, 1966, to December 31, 1996) were conducted to identify clinical trial reports on prompting clinicians. Three eligibility criteria were applied: (1) randomized controlled clinical trial, (2) clinician prompt, alert, or reminder in the study group and no similar intervention in the control group, and (3) measurement of the intervention effect on the frequency of preventive care procedures. Data were abstracted by independent reviewers using a standardized abstraction form, and quality of methodology was scored. A series of meta-analyses on triggering clinical actions was performed using the random-effects method. The statistical analyses included 33 eligible studies, which involved 1547 clinicians and 54 693 patients. Results: Overall, prompting can significantly increase preventive care performance by 13.1% (95% confidence interval [CI], 10.5%-15.6%). However, the effect ranges from 5.8% (95% CI, 1.5%-10.1%) for Papanicolaou smear to 18.3% (95% CI, 11.6%-25.1%) for influenza vaccination. The effect is not cumulative, and the length of intervention period did not show correlation with effect size (R = -0.015, P = .47). Academic affiliation, ratio of residents, and technique of delivery did not have a significant impact on the clinical effect of prompting. Conclusions: Dependable performance improvement in preventive care can be accomplished through prompting physicians. Vigorous application of this simple and effective information intervention could save thousands of lives annually. Health care organizations could effectively use prompts, alerts, or reminders to provide information to clinicians when patient care decisions are made.

Original languageEnglish (US)
Pages (from-to)301-308
Number of pages8
JournalArchives of Internal Medicine
Volume160
Issue number3
DOIs
StatePublished - Feb 14 2000

Fingerprint

Preventive Medicine
Confidence Intervals
Physicians
Papanicolaou Test
Human Influenza
Meta-Analysis
Patient Care
Vaccination
Randomized Controlled Trials
Clinical Trials
Delivery of Health Care
Control Groups
Health

ASJC Scopus subject areas

  • Internal Medicine

Cite this

Balas, E. A., Weingarten, S., Garb, C. T., Blumenthal, D., Boren, S. A., & Brown, G. D. (2000). Improving preventive care by prompting physicians. Archives of Internal Medicine, 160(3), 301-308. https://doi.org/10.1001/archinte.160.3.301

Improving preventive care by prompting physicians. / Balas, E. Andrew; Weingarten, Scott; Garb, Candace T.; Blumenthal, David; Boren, Suzanne Austin; Brown, Gordon D.

In: Archives of Internal Medicine, Vol. 160, No. 3, 14.02.2000, p. 301-308.

Research output: Contribution to journalArticle

Balas, EA, Weingarten, S, Garb, CT, Blumenthal, D, Boren, SA & Brown, GD 2000, 'Improving preventive care by prompting physicians', Archives of Internal Medicine, vol. 160, no. 3, pp. 301-308. https://doi.org/10.1001/archinte.160.3.301
Balas EA, Weingarten S, Garb CT, Blumenthal D, Boren SA, Brown GD. Improving preventive care by prompting physicians. Archives of Internal Medicine. 2000 Feb 14;160(3):301-308. https://doi.org/10.1001/archinte.160.3.301
Balas, E. Andrew ; Weingarten, Scott ; Garb, Candace T. ; Blumenthal, David ; Boren, Suzanne Austin ; Brown, Gordon D. / Improving preventive care by prompting physicians. In: Archives of Internal Medicine. 2000 ; Vol. 160, No. 3. pp. 301-308.
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