Prompting clinicians about preventive care measures: A systematic review of randomized controlled trials
Prompting clinicians about preventive care measures: A systematic review of randomized controlled trials
复制标题
DOI：
10.1197/jamia.m2555
复制
发表时间：
2008-05-01
影响因子：
6.4
通讯作者：
Aronsky, Dominik
中科院分区：
文献类型：
--
作者：
Dexheimer, Judith W.;Talbot, Thomas R.;Aronsky, Dominik
尽管建议增加预防性护理措施的使用，但预防性护理措施仍未得到充分利用。本次综述的目的是检查基于纸质和计算机的预防性护理措施干预措施的特征、类型和效果。该研究对之前的系统评价进行了更新。我们纳入了实施医生提醒并测量对提供预防性护理频率的影响的随机对照试验。在确定的 1,535 篇文章中，有 28 篇符合纳入标准，并与之前审查的 33 篇研究相结合。这些研究涉及 264 项预防性护理干预措施、4,638 名临床医生和 144,605 名患者。实施策略包括 34 项研究 (56%) 中的纸质提醒与计算机生成的提醒相结合，19 项研究 (31%) 中的纸质提醒，以及 8 项研究 (13%) 中的完全计算机化提醒。三种策略在提供预防性护理措施方面的平均增幅在 12% 至 14% 之间。心脏护理和戒烟提醒最有效。计算机生成的提示是最常用的提醒。临床医生提醒是提高预防性护理率的成功方法；然而，它们的效果仍然有限。尽管电子健康记录的实施有所增加，但评估计算机提醒系统的随机对照试验却很少见。
Preventive care measures remain underutilized despite recommendations to increase their use. The objective of this review was to examine the characteristics, types, and effects of paper- and computer-based interventions for preventive care measures. The study provides an update to a previous systematic review. We included randomized controlled trials that implemented a physician reminder and measured the effects on the frequency of providing preventive care. Of the 1,535 articles identified, 28 met inclusion criteria and were combined with the 33 studies from the previous review. The studies involved 264 preventive care interventions, 4,638 clinicians and 144,605 patients. Implementation strategies included combined paper-based with computer generated reminders in 34 studies (56%), paper-based reminders in 19 studies (31%), and fully computerized reminders in 8 studies (13%). The average increase for the three strategies in delivering preventive care measures ranged between 12% and 14%. Cardiac care and smoking cessation reminders were most effective. Computer-generated prompts were the most commonly implemented reminders. Clinician reminders are a successful approach for increasing the rates of delivering preventive care; however, their effectiveness remains modest. Despite increased implementation of electronic health records, randomized controlled trials evaluating computerized reminder systems are infrequent.