Patient reminder and recall interventions to improve immunization rates

Jacobson Vann JC et al. (2018)

Cochrane Database of Systematic Reviews - 10.1002/14651858.CD003941.pub3

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Evidence Categories

• Care setting: Secondary Care
• Care setting: Other settings
• Care setting: Primary care
• Population group: Pre existing health condition
• Population group: Pregnancy/ post-partum
• Population group: Older adults
• Population group: Other population group
• Population group: Men who have sex with men
• Intervention: Reminder/recall (patient)
• Outcome: Uptake of vaccinations

Type of Evidence

Systematic Review

Aims

To evaluate and compare the effectiveness of various types of patient reminder and recall interventions to improve receipt of immunizations.

Findings

The authors state:

"The 75 included studies involved child, adolescent, and adult participants in outpatient, community‐based, primary care, and other settings in 10 countries.

Patient reminder or recall interventions, including telephone and autodialer calls, letters, postcards, text messages, combination of mail or telephone, or a combination of patient reminder or recall with outreach, probably improve the proportion of participants who receive immunization (risk ratio (RR) of 1.28, 95% confidence interval (CI) 1.23 to 1.35; risk difference of 8%) based on moderate certainty evidence from 55 studies with 138,625 participants.

Three types of single‐method reminders improve receipt of immunizations based on high certainty evidence: the use of postcards (RR 1.18, 95% CI 1.08 to 1.30; eight studies; 27,734 participants), text messages (RR 1.29, 95% CI 1.15 to 1.44; six studies; 7772 participants), and autodialer (RR 1.17, 95% CI 1.03 to 1.32; five studies; 11,947 participants). Two types of single‐method reminders probably improve receipt of immunizations based on moderate certainty evidence: the use of telephone calls (RR 1.75, 95% CI 1.20 to 2.54; seven studies; 9120 participants) and letters to patients (RR 1.29, 95% CI 1.21 to 1.38; 27 studies; 81,100 participants).

 Reminders probably improve receipt of vaccinations for childhood influenza (RR 1.51, 95% CI 1.14 to 1.99; risk difference of 22%; five studies; 9265 participants) and adult influenza (RR 1.29, 95% CI 1.17 to 1.43; risk difference of 9%; 15 studies; 59,328 participants) based on moderate certainty evidence. They may improve receipt of vaccinations for adult pneumococcus, tetanus, hepatitis B, and other non‐influenza vaccinations based on low certainty evidence although the confidence interval includes no effect of these interventions (RR 2.08, 95% CI 0.91 to 4.78; four studies; 8065 participants)."

Conclusions

The authors state:

"Patient reminder and recall systems, in primary care settings, are likely to be effective at improving the proportion of the target population who receive immunizations."