Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
Review
. 2012 Aug 16:1:36.
doi: 10.1186/2046-4053-1-36.

Overview of systematic reviews of the effectiveness of reminders in improving healthcare professional behavior

Amy Cheung  1 , Michelle Weir, Alain Mayhew, Nicole Kozloff, Kaitlyn Brown, Jeremy Grimshaw
Affiliations
Review

Overview of systematic reviews of the effectiveness of reminders in improving healthcare professional behavior

Amy Cheung et al. Syst Rev. .

Abstract

Objective: The purpose of this project was to conduct an overview of existing systematic reviews to evaluate the effectiveness of reminders in changing professional behavior in clinical settings.

Materials and methods: Relevant systematic reviews of reminder interventions were identified through searches in MEDLINE, EMBASE, DARE and the Cochrane Library in conjunction with a larger project examining professional behavioral change interventions. Reviews were appraised using AMSTAR, a validated tool for assessing the quality of systematic reviews. As most reviews only reported vote counting, conclusions about effectiveness for each review were based on a count of positive studies. If available, we also report effect sizes. Conclusions were based on the findings from higher quality and current systematic reviews.

Results: Thirty-five reviews were eligible for inclusion in this overview. Ten reviews examined the effectiveness of reminders generally, 5 reviews focused on specific health care settings, 14 reviews concentrated on specific behaviors and 6 reviews addressed specific patient populations. The quality of the reviews was variable (median = 3, range = 1 to 8). Seven reviews had AMSTAR scores >5 and were considered in detail. Five of these seven reviews demonstrated positive effects of reminders in changing provider behavior. Few reviews used quantitative pooling methods; in one high quality and current review, the overall observed effects were moderate with an absolute median improvement in performance of 4.2% (IQR: 0.5% to 6.6%).

Discussion: The results support that modest improvements can occur with the use of reminders. The effect size is consistent with other interventions that have been used to improve professional behavior.

Conclusion: Reminders appear effective in improving different clinical behaviors across a range of settings.

PubMed Disclaimer

Figures

Figure 1
Figure 1
Flow diagram of selected reviews. Reviews included in the Rx for Change database that examined professional behavior change interventions.
Figure 2
Figure 2
Publication year of included reviews.
Figure 3
Figure 3
AMSTAR scores of included reviews. AMSTAR scores of included reviews.
See this image and copyright information in PMC

References

    1. MacDonald CJ. Protocol-based computer reminders, the quality of care and the non-perfectibility of man. N Engl J Med. 1976;24:1351–1355. - PubMed
    1. Haynes RB, Walker CJ. Computer-aided quality assurance. A critical appraisal. Arch Intern Med. 1987;7:1297–1301. - PubMed
    1. Weir CR, Staggers N, Phansalkar S. The state of the evidence for computerized provider order entry: a systematic review and analysis of the quality of the literature. Int J Med Inform. 2009;78:365–374. doi: 10.1016/j.ijmedinf.2008.12.001. - DOI - PubMed
    1. Becker LA Oxman AD. In: Cochrane Handbook for Systematic Reviews of Interventions Version 501 . Higgins JPT, Green S, editor. 2008. Chapter 22: Overviews of reviews. Higgins JPT, Green S (editors). Cochrane Handbook for Systematic Reviews of Interventions Version 5.1.0 [updated March 2011]. The Cochrane Collaboration, 2011. Available from http://www.cochrane-handbook.org.
    1. Bero LA, Grilli R, Grimshaw JM, Harvey E, Oxman AD. Getting research findings into practice. Closing the gap between research and practice: an overview of systematic reviews of interventions to promote the implementation of research findings. BMJ. 1998;317(7156):465–468. doi: 10.1136/bmj.317.7156.465. - DOI - PMC - PubMed

Publication types