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Improving Preventive Care by Prompting Physicians
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 impa…
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“Some systematic evidence of the benefits of e-health in general, [2][3][4] and of specific areas of e-health, such as decision-support systems for clinicians 5,6 or patient-targeted text messaging, 7-10 already exists.”
From Impacts of e-health on the outcomes of care in low- and middle-income countries: where do we go from here? (2012) · cites this paper as [6]
In the citing paper
“In a series of metaanalyses, the prompting of clinicians via electronic medical record systems was found to increase the number of guideline-recommended preventive care services that were performed by a mean of 13%.”
From Impacts of e-health on the outcomes of care in low- and middle-income countries: where do we go from here? (2012) · cites this paper as [6]
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Metadata
- Authors
- Balas, E. A.
- Affiliations
- University of Missouri (US)
- Corresponding author
- Balas, E. A.
- ORCID
- Balas, E. A.
- Venue
- Archives of Internal Medicine
- Publisher
- American Medical Association (AMA)
- Published
- 2000-02-14
- Volume
- 160
- Issue
- 3
- Pages
- 301-308
- ISSN
- 0003-9926 (ISSN-L)
- OpenAlex
- W2168700574
- Cited by
- 385
- References
- 60
- Citations by year
- 2026: 3 · 2024: 2 · 2023: 2 · 2022: 7 · 2021: 10 · 2020: 7 · 2019: 6 · 2018: 12 · 2017: 11 · 2016: 12 · 2015: 15 · 2014: 17 · 2013: 14 · 2012: 23
- FWCI
- 59.57
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- Archives of Internal Medicine (publishedVersion)
- PubMed (publishedVersion)
- Funders
- U.S. National Library of Medicine (LM05545)
- Topics
- Health Sciences › Health Professions › Health Information Management › Electronic Health Records Systems
- Health Sciences › Medicine › Public Health, Environmental and Occupational Health › Health Promotion and Cardiovascular Prevention
- Health Sciences › Medicine › Public Health, Environmental and Occupational Health › Clinical practice guidelines implementation
- Keywords
- preventive medicine, health maintenance, Pap smear, influenza vaccination, information interventions, mode of delivery, randomized controlled trials
- MeSH terms
- Humans, Practice Patterns, Physicians', Preventive Medicine, Quality Assurance, Health Care, Retrospective Studies, Randomized Controlled Trials as Topic
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