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Systematic Review
The CPSTF recommends provider reminders on the basis of strong evidence of effectiveness in increasing vaccination rates: (1) among adults, adolescents and children; (2) when used alone or with additional interventions; (3) across a range of intervention characteristics (e.g., computerized or simple reminders, checklists, flowcharts); and (4) in a range of settings and populations.
The Task Force finding is based on evidence from a Community Guide systematic review completed in 2008 (23 studies, search period 1997–2007) combined with more recent evidence (5 studies, search period 2007–February 2012). Based on the combined evidence, the Task Force reaffirms its recommendation based on strong evidence of effectiveness.
The Task Force considered evidence from 28 studies. Twenty-two studies provided a measurement of change in vaccination rates, with an overall median increase of 10 percentage points (IQI: 6 to 25 percentage points). Of these, seven studies examined provider reminders alone with a median increase of 12 percentage points (IQI: 6 percentage point to 25 percentage points). Fifteen studies examined the impact of provider reminders with additional interventions and observed a median increase of 9 percentage points (IQI: 5 to 25 percentage points). Six additional studies did not provide a common measurement of change in vaccination rates; however, five of the studies provided additional support for the use of provider reminders.
Evidence indicates that provider reminders remain an effective option for consideration in a wide range of clinical settings and populations. A subset of the included evidence, however, suggests that standing orders may be more effective in improving vaccination rates in both inpatient and outpatient settings than provider reminder systems.
Evidence in this CPSTF report indicates that provider reminders are effective in a wide range of contexts. Additional research should focus on system-level implementation of reminder systems, and identify strategies to encourage regular and sustained use. In addition, future research could examine or compare the effectiveness of specific reminder prompts provided as a capability of regional or state-level immunization information systems.