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Adolygiad Systematig
The CPSTF recommends interventions that reduce client out-of-pocket costs based on strong evidence of effectiveness in improving vaccination rates. The effectiveness of these interventions has been demonstrated among children, adolescents, and adults, in a range of settings and populations, when applied in varying levels of scale from individual clinical settings to statewide programs to national efforts, and whether used alone or as part of a multi-component intervention.
This Task Force finding is based on evidence from a Community Guide systematic review completed in 2008 (19 studies, search period 1997-2007) combined with more recent evidence (10 studies, search period 2007-2012). Based on the combined evidence, the Task Force reaffirms its recommendation based on strong evidence of effectiveness.
Included studies showed vaccination rates increased by a median of 11 percentage points (IQI: 4 to 17 percentage points). Client reminder and recall interventions used alone resulted in a median increase of 6 percentage points (IQI: 3 to 13 percentage points; 14 studies), and interventions implemented with additional components led to a median increase of 12 percentage points (IQI: 10 to 30 percentage points; 15 studies).
The included studies evaluated the effectiveness of client reminder and recall interventions for a wide range of client and provider populations, settings, vaccinations and delivery methods. Based on the evidence, the Task Force finding should be broadly applicable to all patient populations, in both clinical and community settings, and for the range of vaccines and delivery methods.
This CPSTF concludes that client reminder and recall systems can also be important, effective components of combined approaches to increase vaccination rates. Based on updated, concurrent reviews, the Task Force finds strong evidence to recommend health care system-based interventions implemented in combination and community-based interventions implemented in combination. Immunization information systems, which can also generate client reminder or recall notices provide an additional implementation option.
More research is needed on effective implementation, sustainability, and expansion of reminder and recall interventions. Future research should also examine the effectiveness of reminder and recall notices using emerging communication technologies (i.e. text message, email). Additional studies should also examine the effectiveness of client reminder and recall interventions on adolescent vaccines such as the HPV.