All six of the reminder and recall systems tested -- including post cards, letters and phone calls -- resulted in better immunization coverage, the review finds. The boost in immunization rates held true for both adults and children -- and across an array of clinical settings.

The review, which encompasses 43 patient-reminder studies, found immunization increases "in the range of 1 to 20 percentage points."

Study co-author Julie C. Jacobson Vann, Ph.D., says physicians in private practice, public health departments or academic medical centers can feel confident about setting up a patient reminder or recall system for immunizations. "I think it's a very simple intervention for the fast-paced lives most of us lead," she says.

When the reviewers pooled the results from the reminder and recall systems studied, they found that those patients who were reminded were 70 percent more likely to have been immunized.

The review appears in the July issue of The Cochrane Library, a publication of The Cochrane Collaboration, an international organization that evaluates medical research. Systematic reviews draw evidence-based conclusions about medical practice after considering both the content and quality of existing medical trials on a topic.

The review found that four of the six reminder tools or systems created statistically significant improvements in immunization rates.

Person-to-person telephone reminders created the greatest gains in immunization rates, with almost twice as high a chance of patients being immunized. By contrast, computerized auto-dialer reminders only achieved a 43 percent greater likelihood of compliance.

Among the mailed reminders, letters were much more effective than postcards, the review found.

In addition to patient reminders, three studies measured the combi
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Contact: Julie Jacobson Vann
jvann@ncaccesscare.org
Center for the Advancement of Health
19-Jul-2005