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Professional Intervention: Reminders - general


Patient or encounter specific information, provided verbally, on paper or on a computer screen, which is designed or intended to prompt a health professional to recall information. This would usually be encountered through their general education; in the medical records or through interactions with peers, and so remind them to perform or avoid some action to aid individual patient care. Computer aided decision support is included.


Fourteen high quality reviews (Arditi, Archer, Boyle, Bradley, Dwamena, Free, French, Laliberte, Little, Newton, O'Brien, Pirkis, Shojania, Thomas) and two key reviews (Arnold, Davey) were identified. Results from five high quality reviews (Arditi, Boyle, French, Laliberte, Shojania) show that reminder interventions are generally effective for improving appropriate care behaviour; the results from the Shojania review also found this to be effective for improving prescribing related behaviours, while Arditi found mixed results for improving choice of drug. Nine high quality reviews (Arcger, Bradley, Dwamena, Free, Little, Newton, O'Brien, Thomas, Pirkis) and two key reviews (Arnold, Davey) had an insufficient number of studies to draw any conclusions about the effectiveness of the intervention.

Summary of Overall Findings from Reviews

71 reviews evaluating the effectiveness of general reminders were identified. Of these, 5/5 high quality/key reviews with a sufficient number of studies to draw conclusions found this intervention to be generally effective.

Summary of Findings Related to Prescribing

1/2 high quality/key reviews with a sufficient number of studies to draw conclusions found this intervention to be generally effective for improving prescribing outcomes. One high quality review (Arditi) had mixed results.

Reviews listed as "Summary Pending" will be analyzed, summarized and reported at a later date.

The findings will then be incorporated in the overall evidence summaries of the interventions they address.

Reviews Addressing This Intervention Quality Assessment Tool:
AMSTAR Score (of 11 points)
Pappas Y, Atherton H, Sawmynaden P, Car J. Email for clinical communication between healthcare professionals. Cochrane Database of Systematic Reviews 2012 9:CD007979. 10
Summary Pending
Archer J, Bower P, Gilbody S, Lovell K, Richards D, Gask L, Dickens C, Coventry P. Collaborative care for depression and anxiety problems. Cochrane Database of Systematic Reviews 2012 10:CD006525. 9 (High)
Boyle R, Solberg L, Fiore M. Use of electronic health records to support smoking cessation. Cochrane Database of Systematic Reviews 2011 12:CD008743. 9 (High)
Bradley PM, Lindsay B. Care delivery and self-management strategies for adults with epilepsy. Cochrane Database of Systematic Reviews 2008 1:CD006244. 9 (High)
French SD, Green S, Buchbinder R, Barnes H. Interventions for improving the appropriate use of imaging in people with musculoskeletal conditions. Cochrane Database of Systematic Reviews 2010 1:CD006094. 9 (High)
Laliberte MC, Perreault S, Jouini G, Shea BJ, Lalonde L. Effectiveness of interventions to improve the detection and treatment of osteoporosis in primary care settings: a systematic review and meta-analysis. Osteoporosis International 2011 22 (11):2743-68. 9 (High)
Little EA, Eccles MP. A systematic review of the effectiveness of interventions to improve post-fracture investigation and management of patients at risk of osteoporosis. Implementation Science 2010 5 (1):80-97. 9 (High)
Arditi C, Rege-Walther M, Wyatt JC, Durieux P, Burnand B. Computer-generated reminders delivered on paper to healthcare professionals; effects on professional practice and health care outcomes. Cochrane Database of Systematic Reviews 2012 12:CD001175. 8 (High)
Dwamena F, Holmes-Rovner M, Gaulden CM, Jorgenson S, Sadigh G, Sikorskii A, Lewin S, Smith RC, Coffey J, Olomu A. Interventions for providers to promote a patient-centred approach in clinical consultations. Cochrane Database of Systematic Reviews 2012 12:CD003267. 8 (High)
Free C, Phillips G, Watson L, Galli L, Felix L, Edwards P, Patel V, Haines A. The effectiveness of mobile-health technologies to improve health care service delivery processes: a systematic review and meta-analysis. PLoS Medicine 2013 10 (1):e1001363. 8 (High)
Ivers N, Jamtvedt G, Flottorp S, Young JM, Odgaard-Jensen J, French SD, O'Brien MA, Johansen M, Grimshaw J, Oxman AD. Audit and feedback: effects on professional practice and healthcare outcomes. Cochrane Database of Systematic Reviews 2012 6:CD000259. 8
Summary Pending
Newton AS, Zou B, Hamm MP, Curran J, Gupta S, Dumonceaux C, Lewis M. Improving child protection in the emergency department: a systematic review of professional interventions for health care providers. Academic Emergency Medicine 2010 17 (2):117-25. 8 (High)
O'Brien MA, Rogers S, Jamtvedt G, Oxman AD, Odgaard-Jensen J, Kristoffersen DT, Forsetlund L, Bainbridge D, Freemantle N, Davis DA, Haynes RB, Harvey EL. Educational outreach visits: effects on professional practice and health care outcomes. Cochrane Database of Systematic Reviews 2007 4:CD000409. 8 (High)
Pirkis JE, Jolley D, Dunt DR. Recruitment of women by GPs for pap tests: a meta-analysis. British Journal of General Practice 1998 48 (434):1603-7. 8 (High)
Shojania KG, Jennings A, Mayhew A, Ramsay CR, Eccles MP, Grimshaw J. The effects of on-screen, point of care computer reminders on processes and outcomes of care. Cochrane Database of Systematic Reviews 2009 3:CD001096. 8 (High)
Thomas L, Cullum N, McColl E, Rousseau N, Soutter J, Steen N. Guidelines in professions allied to medicine. Cochrane Database of Systematic Reviews 2000 2:CD000349. 8 (High)
Akbari A, Mayhew A, Al-Alawi MA, Grimshaw J, Winkens R, Glidewell E, Pritchard C, Thomas R, Fraser C. Interventions to improve outpatient referrals from primary care to secondary care. Cochrane Database of Systematic Reviews 2008 4:CD005471. 7 (Medium)
Arnold SR, Straus SE. Interventions to improve antibiotic prescribing practices in ambulatory care. Cochrane Database of Systematic Reviews 2005 4:CD003539. 7 (Medium)
Davey P, Brown E, Fenelon L, Finch R, Gould I, Hartman G, Holmes A, Ramsay C, Taylor E, Wilcox M, Wiffen P. Interventions to improve antibiotic prescribing practices for hospital inpatients. Cochrane Database of Systematic Reviews 2005 4:CD003543. 7 (Medium)
Fernando B, Kalra D, Morrison Z, Byrne E, Sheikh A. Benefits and risks of structuring and/or coding the presenting patient history in the electronic health record: systematic review. BMJ Quality & Safety 2012 21 (4):337-46. 7 (Medium)
Glynn LG, Murphy AW, Smith SM, Schroeder K, Fahey T. Interventions used to improve control of blood pressure in patients with hypertension. Cochrane Database of Systematic Reviews 2010 3:CD005182. 7 (Medium)
Grimshaw JM, Thomas RE, MacLennan G, Fraser C, Ramsay CR, Vale L, Whitty P, Eccles MP, Matowe L, Shirran L, Wensing M, Dijkstra R, Donaldson C. Effectiveness and efficiency of guideline dissemination and implementation strategies. Health Technology Assessment 2004 8 (6):iii-iiv. 7 (Medium)
Kastner M, Straus SE. Clinical decision support tools for osteoporosis disease management: A systematic review of randomized controlled trials. Journal of General Internal Medicine 2008 23 (12):2095-105. 7 (Medium)
Lancaster T, Silagy C, Fowler G. Training health professionals in smoking cessation. Cochrane Database of Systematic Reviews 2000 3:CD000214. 7 (Medium)
Lindenmeyer A, Hearnshaw H, Vermeire E, Van RP, Wens J, Biot Y. Interventions to improve adherence to medication in people with type 2 diabetes mellitus: a review of the literature on the role of pharmacists. Journal of Clinical Pharmacy and Therapeutics 2006 31 (5):409-19. 7 (Medium)
McKibbon KA, Lokker C, Handler SM, Dolovich LR, Holbrook AM, O'Reilly D, Tamblyn R, Hemens BJ. Basu R. Troyan S. Roshanov PS. Archer NP. Raina P. Enabling medication management through health information technology. Agency for Healthcare Research and Quality Technical Reviews 2011 Evidence R (11-E008-EF). 7 (Medium)
Renders CM, Valk GD, Griffin S, Wagner EH, Eijk JT, Assendelft WJ. Interventions to improve the management of diabetes mellitus in primary care, outpatient and community settings. Cochrane Database of Systematic Reviews 2001 1:CD001481. 7 (Medium)
Siddiqui MR, Sajid MS, Khatri K, Kanri B, Cheek E, Baig MK. The role of physician reminders in faecal occult blood testing for colorectal cancer screening. European Journal of General Practice 2011 17 (4):221-8. 7 (Medium)
Thomas RE, Russell ML, Lorenzetti DL. Systematic review of interventions to increase influenza vaccination rates of those 60 years and older. Vaccine 2010 28 (7):1684-701. 7 (Medium)
Brusamento S, Legido-Quigley H, Panteli D, Turk E, Knai C, Saliba V, Car J, McKee M, Busse R. Assessing the effectiveness of strategies to implement clinical guidelines for the management of chronic diseases at primary care level in EU Member States: a systematic review. Health Policy 2012 107 (41700):169-183. 6
Summary Pending
Bywood PT, Lunnay B, Roche AM. Strategies for facilitating change in alcohol and other drugs (AOD) professional practice: a systematic review of the effectiveness of reminders and feedback. Drug and Alcohol Review 2008 27 (5):548-58. 6 (Medium)
Duckers M, Faber M, Cruijsberg J, Grol R, Schoonhoven L, Wensing M. Safety and risk management interventions in hospitals: a systematic review of the literature. Medical Care Research and Review 2009 66 (Suppl 6):90S-119S. 6 (Medium)
Gilbody S, Whitty P, Grimshaw J, Thomas R. Educational and organizational interventions to improve the management of depression in primary care: a systematic review. JAMA 2003 289 (23):3145-51. 6 (Medium)
Jamal J, McKenzie K, Clark M. The impact of health information technology on the quality of medical and health care: a systematic review. The HIM journal 2009 38 (3):26-37. 6 (Medium)
Kawamoto K, Lobach D. Clinical decision support provided within physician order entry systems: a systematic review of features effective for changing clinician behavior. AMIA Annual Symposium Proceedings 2003:361-5. 6 (Medium)
Ko HC, Turner TJ, Finnigan MA. Systematic review of safety checklists for use by medical care teams in acute hospital settings--limited evidence of effectiveness. BMC Health Services Research 2011 11:211. 6 (Medium)
Lau D, Hu J, Majumdar SR, Storie DA, Rees SE, Johnson JA. Interventions to improve influenza and pneumococcal vaccination rates among community-dwelling adults: a systematic review and meta-analysis. Annals of Family Medicine 2012 10 (6):538-546. 6
Summary Pending
Ranji SR, Steinman MA, Shojania KG, Gonzales R. Interventions to reduce unnecessary antibiotic prescribing: a systematic review and quantitative analysis. Medical Care 2008 46 (8):847-62. 6 (Medium)
Ricci-Cabello I, Ruiz-Perez I, Nevot-Cordero A, Rodriguez-Barranco M, Sordo L, Goncalves DC. Health care interventions to improve the quality of diabetes care in African Americans: a systematic review and meta-analysis. Diabetes Care 2013 36 (3):760-768. 6
Summary Pending
Saxena S, Misra T, Car J, Netuveli G, Smith R, Majeed A. Systematic review of primary healthcare interventions to improve diabetes outcomes in minority ethnic groups. Journal of Ambulatory Care Management 2007 30 (3):218-30. 6 (Medium)
Williams N, Woodward H, Majeed A, Saxena S. Primary care strategies to improve childhood immunisation uptake in developed countries: systematic review. JRSM Short Reports 2011 2 (10):81, 2011. 6 (Medium)
Baron RC, Melillo S, Rimer BK, Coates RJ, Kerner J, Habarta N, Chattopadhyay S, Sabatino SA, Elder R, Leeks KJ. Intervention to increase recommendation and delivery of screening for breast, cervical, and colorectal cancers by healthcare providers a systematic review of provider reminders. American Journal of Preventive Medicine 2010 38 (1):110-7. 5 (Medium)
Beach MC, Gary TL, Price EG, Robinson K, Gozu A, Palacio A, Smarth C, Jenckes M, Feuerstein C, Bass EB, Powe NR, Cooper LA. Improving health care quality for racial/ethnic minorities: a systematic review of the best evidence regarding provider and organization interventions. BMC Public Health [electronic resource] 2006 6:104. 5 (Medium)
Bordley WC, Chelminski A, Margolis PA, Kraus R, Szilagyi PG, Vann JJ. The effect of audit and feedback on immunization delivery: a systematic review. American Journal of Preventive Medicine 2000 18 (4):343-50. 5 (Medium)
Castelino R, Bajorek B, Chen T. Targeting suboptimal prescribing in the elderly: a review of the impact of pharmacy services. The Annals of Pharmacotherapy 2009 43 (6):1096-106. 5 (Medium)
Cleveringa FG, Gorter KJ, van den Donk M, van GJ, Rutten GE. Computerized decision support systems in primary care for type 2 diabetes patients only improve patients' outcomes when combined with feedback on performance and case management: a systematic review. Diabetes Technology & Therapeutics 2013 15 (2):180-192. 5
Summary Pending
Dijkstra R, Wensing M, Thomas R, Akkermans R, Braspenning J, Grimshaw J, Grol R. The relationship between organisational characteristics and the effects of clinical guidelines on medical performance in hospitals, a meta-analysis. BMC Health Services Research 2006 6:53. 5 (Medium)
Gyorkos TW, Tannenbaum TN, Abrahamowicz M, Bedard L, Carsley J, Franco ED, Delage G, Miller MA, Lamping DL, Grover SA. Evaluation of the effectiveness of immunization delivery methods. Canadian Journal of Public Health 1994 85 (Suppl 1):S14-30. 5 (Medium)
Hakkennes S, Dodd K. Guideline implementation in allied health professions: a systematic review of the literature. Quality and Safety in Health Care 2008 17 (4):296-300. 5 (Medium)
Holt TA, Thorogood M, Griffiths F. Changing clinical practice through patient specific reminders available at the time of the clinical encounter: systematic review and meta-analysis. Journal of General Internal Medicine 2012 27 (8):974-984. 5
Summary Pending
Hulscher ME, Wensing M, van Der Weijden T, Grol R. Interventions to implement prevention in primary care. Cochrane Database of Systematic Reviews 2001 1:CD000362. 5 (Medium)
Ista E, van DM, van AT. Do implementation strategies increase adherence to pain assessment in hospitals? A systematic review. International Journal of Nursing Studies 2013 50 (4):552-568. 5
Summary Pending
Pasricha A, Deinstadt RT, Moher D, Killoran A, Rourke SB, Kendall CE. Chronic Care Model Decision Support and Clinical Information Systems interventions for people living with HIV: a systematic review. Journal of General Internal Medicine 2013 28 (1):127-135. 5
Summary Pending
Perry M, Draaskovic I, Lucassen P, Vernooij-Dassen M, van AT, Rikkert M. Effects of educational interventions on primary dementia care: A systematic review. International Journal of Geriatric Psychiatry 2011 26 (1):1-11. 5 (Medium)
Redfern J, McKevitt C, Wolfe CD. Development of complex interventions in stroke care: a systematic review. Stroke 2006 37 (9):2410-9. 5 (Medium)
Schedlbauer A, Prasad V, Mulvaney C, Phansalkar S, Stanton W, Bates DW, Avery AJ. What evidence supports the use of computerized alerts and prompts to improve clinicians' prescribing behavior? Journal of the American Medical Informatics Association 2009 16 (4):531-8. 5 (Medium)
Schlenk EA, Bernardo LM, Organist LA, Klem ML, Engberg S. Optimizing medication adherence in older patients: a systematic review. Journal of Clinical Outcomes Management 2008 15 (12):595-606. 5 (Medium)
Solomon DH, Hashimoto H, Daltroy L, Liang MH. Techniques to improve physicians' use of diagnostic tests: a new conceptual framework. JAMA 1998 280 (23):2020-7. 5 (Medium)
Wilson K, MacDougall L, Fergusson D, Graham I, Tinmouth A, Hebert PC. The effectiveness of interventions to reduce physician's levels of inappropriate transfusion: what can be learned from a systematic review of the literature. Transfusion 2002 42 (9):1224-9. 5 (Medium)
Anderson LA, Janes GR, Jenkins C. Implementing preventive services: to what extent can we change provider performance in ambulatory care? A review of the screening, immunization, and counseling literature. Annals of Behavioral Medicine 1998 20 (3):161-7. 4 (Medium)
Balas E, Krishna S, Kretschmer R, Cheek T, Lobach D, Boren S. Computerized knowledge management in diabetes care. Medical Care 2004 42 (6):610-21. 4 (Medium)
Balas EA, Weingarten S, Garb CT, Blumenthal D, Boren SA, Brown GD. Improving preventive care by prompting physicians. Archives of Internal Medicine 2000 160 (3):301-8. 4 (Medium)
Bennett JW, Glasziou PP. Computerised reminders and feedback in medication management: a systematic review of randomised controlled trials. The Medical journal of Australia 2003 178 (5):217-22. 4 (Medium)
Borchard A, Schwappach DL, Barbir A, Bezzola P. A systematic review of the effectiveness, compliance, and critical factors for implementation of safety checklists in surgery. Annals of Surgery 2012 256 (6):925-933. 4
Summary Pending
Chaillet N, Dube E, Dugas M, Audibert F, Tourigny C, Fraser WD, Dumont A. Evidence-based strategies for implementing guidelines in obstetrics: a systematic review. Obstetrics and Gynecology 2006 108 (5):1234-45. 4 (Medium)
Chan AJ, Chan J, Cafazzo JA, Rossos PG, Tripp T, Shojania K, Khan T, Easty AC. Order sets in health care: a systematic review of their effects. International Journal of Technology Assessment in Health Care 2012 28 (3):235-240. 4
Summary Pending
Chaudhry B, Wang J, Wu S, Maglione M, Mojica W, Roth E, Morton SC, Shekelle PG. Systematic review: impact of health information technology on quality, efficiency, and costs of medical care. Annals of Internal Medicine 2006 144 (10):742-52. 4 (Medium)
Cooper JG, West RM, Clamp SE, Hassan TB. Does computer-aided clinical decision support improve the management of acute abdominal pain? A systematic review. Emergency Medicine Journal 2011 28 (7):553-557. 4 (Medium)
Damiani G, Pinnarelli L, Colosimo SC, Almiento R, Sicuro L, Galasso R, Sommella L, Ricciardi W. The effectiveness of computerized clinical guidelines in the process of care: a systematic review. BMC Health Services Research 2010 10:2. 4
Summary Pending
Fischer S, Tjia J, Field T. Impact of health information technology interventions to improve medication laboratory monitoring for ambulatory patients: a systematic review. Journal of the American Medical Informatics Association 2010 17 (6):631-6. 4 (Medium)
Guldberg TL, Lauritzen T, Kristensen JK, Vedsted P. The effect of feedback to general practitioners on quality of care for people with type 2 diabetes. A systematic review of the literature. BMC Family Practice 2009 10:30. 4 (Medium)
Hayward GL, Parnes AJ, Simon SR. Using health information technology to improve drug monitoring: a systematic review. Pharmacoepidemiology and Drug Safety 2009 18 (12):1232-7. 4 (Medium)
Ioannidis JP, Lau J. Evidence on interventions to reduce medical errors: an overview and recommendations for future research. Journal of General Internal Medicine 2001 16 (5):325-34. 4 (Medium)
Katz EB, Carrier ER, Umscheid CA, Pines JM. Comparative effectiveness of care coordination interventions in the emergency department: a systematic review. Annals of Emergency Medicine 2012 60 (1):45261. 4
Summary Pending
LaMantia MA, Scheunemann LP, Viera AJ, Busby-Whitehead J, Hanson LC. Interventions to improve transitional care between nursing homes and hospitals: a systematic review. Journal of the American Geriatrics Society 2010 58 (4):777-82. 4 (Medium)
Lindquist AM, Johansson PE, Petersson GI, Saveman BI, Nilsson GC. The use of the Personal Digital Assistant (PDA) among personnel and students in health care: a review. Journal of Medical and Internet Research 2009 10 (4):e31. 4 (Medium)
Louwers EC, Affourtit MJ, Moll HA, Koning HJ, Korfage IJ. Screening for child abuse at emergency departments: a systematic review. Archives of Disease in Childhood 2010 95 (3):214-8. 4 (Medium)
Mansell G, Shapley M, Jordan JL, Jordan K. Interventions to reduce primary care delay in cancer referral: a systematic review. British Journal of General Practice 2011 61 (593):e821-e835. 4 (Medium)
Meddings J, Rogers M, Macy M, Saint S. Systematic review and meta-analysis: reminder systems to reduce catheter-associated urinary tract infections and urinary catheter use in hospitalized patients. Clinical Infectious Diseases 2010 51 (5):550-60. 4 (Medium)
Mueller SK, Sponsler KC, Kripalani S, Schnipper JL. Hospital-based medication reconciliation practices: a systematic review. Archives of Internal Medicine 2012 172 (14):1057-1069. 4
Summary Pending
Naikoba S, Hayward A. The effectiveness of interventions aimed at increasing handwashing in healthcare workers - a systematic review. The Journal of Hospital Infection 2001 47 (3):173-80. 4 (Medium)
Shea S, DuMouchel W, Bahamonde L. A meta-analysis of 16 randomized controlled trials to evaluate computer-based clinical reminder systems for preventive care in the ambulatory setting. Journal of the American Medical Informatics Association 1996 3 (6):399-409. 4 (Medium)
van Steenkiste B, Grol R, van der Weijden T. Systematic review of implementation strategies for risk tables in the prevention of cardiovascular diseases. Vascular Health and Risk Management 2008 4 (3):535-45. 4 (Medium)
Wensing M, Grol R. Single and combined strategies for implementing changes in primary care: a literature review. International Journal for Quality in Health Care 1994 6 (2):115-32. 4 (Medium)
Yeung J, Meeks R, Edelson D, Gao F, Soar J, Perkins GD. The use of CPR feedback/prompt devices during training and CPR performance: a systematic review. Resuscitation 2009 80 (7):743-51. 4 (Medium)
Catalani C, Philbrick W, Fraser H, Mechael P, Israelski DM. mHealth for HIV Treatment & Prevention: A Systematic Review of the Literature. The open AIDS journal 2013 7:17-41. Summary Pending
Fillmore CL, Bray BE, Kawamoto K. Systematic review of clinical decision support interventions with potential for inpatient cost reduction. BMC Medical Informatics & Decision Making 2013 13 (135). Summary Pending
Jeffery R, Iserman E, Haynes RB, CDSS Systematic Review Team. Can computerized clinical decision support systems improve diabetes management? A systematic review and meta-analysis. Diabetic Medicine 2013 30 (6):739-745. Summary Pending
Kahn SR, Morrison DR, Cohen JM, Emed J, Tagalakis V, Roussin A, Geerts W. Interventions for implementation of thromboprophylaxis in hospitalized medical and surgical patients at risk for venous thromboembolism. Cochrane Database of Systematic Reviews 2013 7:CD008201. Summary Pending
Ojeleye O, Avery A, Gupta V, Boyd M. The evidence for the effectiveness of safety alerts in electronic patient medication record systems at the point of pharmacy order entry: a systematic review. BMC Medical Informatics & Decision Making 2013 13 (69). Summary Pending
Schichtel M, Rose PW, Sellers C. Educational interventions for primary healthcare professionals to promote the early diagnosis of cancer: a systematic review. Education for Primary Care 2013 24 (4):274-290. Summary Pending
Schweizer ML, Reisinger HS, Ohl M, Formanek MB, Blevins A, Ward MA, Perencevich EN. Searching for an Optimal Hand Hygiene Bundle: A Meta-analysis. Clinical Infectious Diseases 2014 58 (2):248-259. Summary Pending
Vodicka TA, Thompson M, Lucas P, Heneghan C, Blair PS, Buckley DI, Redmond N, Hay AD, TARGET Programme team. Reducing antibiotic prescribing for children with respiratory tract infections in primary care: a systematic review. British Journal of General Practice 2013 63 (612):e454. Summary Pending