The effect of patient-carried reminder cards on the performance of health maintenance measures.

We designed a card that patients carried and showed to their physicians at scheduled appointments to remind them to perform six health maintenance procedures: influenza vaccination, pneumococcal vaccination, rectal examination and hemoccult test, Papanicolaou's smear, physician breast examination, and mammography. Prompt sheets were also attached to all charts to remind physicians to perform these same procedures. One hundred seventy-five patients received the card and the physician prompt sheets on their charts. Two hundred forty-eight patients received only physician's prompt sheet. The card group had significant increases in the performance of influenza vaccinations (47% vs 29%), rectal examination and hemoccult tests (59% vs 46%), Papanicolaou's smears, (30% vs 20%), and physician breast examinations (52% vs 29%). There was not a significant increase in the performance of pneumococcal vaccines (22% vs 24%) or mammography (18% vs 19%). We conclude that patient-carried health maintenance reminder cards are useful in increasing the physician performance of influenza vaccinations, rectal examinations and hemoccult tests, Papanicolaou's smears, and breast examinations.