BACKGROUND: We evaluated the effectiveness of 2 reminder interventions to increase the use of screening mammograms and Papanicolaou (Pap) smears among female members of a large health maintenance organization. METHODS:Seven thousand seventy-seven female health maintenance organization members (aged 50-74 years with no prior mammogram in the previous 30 months or aged 20-64 years with no prior Pap smear in the previous 36 months) were randomized to receive one of the following: a letter inviting them to make an appointment for a mammogram or a Pap smear; in addition to the letter, a reminder manually placed in the patient's medical chart alerting providers of that member's need for screening; or their usual care. RESULTS: Compared with women who did not receive the reminder letter, women who did receive the letter were more likely to obtain mammograms (16.0% vs 25.5%, respectively; P < .001) or Pap smears (9.1% vs 19.5%, respectively; P < .001) in the 6 months following their entry into the study. Compared with women who received only the reminder letter, women who received a reminder letter and had a reminder placed in their medical chart were more likely to obtain mammograms (26.5% vs 30.9%, respectively; P = .02) and marginally more likely to receive Pap smears (19.5% vs 22.8%, respectively; P = .04). CONCLUSIONS: We recommend the use of patient reminder letters as a first step in a mammography or Pap smear screening outreach program. Further research is needed to evaluate a cost-effective provider reminder system and additional outreach strategies directed to women who do not use health care services.
RCT Entities:
BACKGROUND: We evaluated the effectiveness of 2 reminder interventions to increase the use of screening mammograms and Papanicolaou (Pap) smears among female members of a large health maintenance organization. METHODS: Seven thousand seventy-seven female health maintenance organization members (aged 50-74 years with no prior mammogram in the previous 30 months or aged 20-64 years with no prior Pap smear in the previous 36 months) were randomized to receive one of the following: a letter inviting them to make an appointment for a mammogram or a Pap smear; in addition to the letter, a reminder manually placed in the patient's medical chart alerting providers of that member's need for screening; or their usual care. RESULTS: Compared with women who did not receive the reminder letter, women who did receive the letter were more likely to obtain mammograms (16.0% vs 25.5%, respectively; P < .001) or Pap smears (9.1% vs 19.5%, respectively; P < .001) in the 6 months following their entry into the study. Compared with women who received only the reminder letter, women who received a reminder letter and had a reminder placed in their medical chart were more likely to obtain mammograms (26.5% vs 30.9%, respectively; P = .02) and marginally more likely to receive Pap smears (19.5% vs 22.8%, respectively; P = .04). CONCLUSIONS: We recommend the use of patient reminder letters as a first step in a mammography or Pap smear screening outreach program. Further research is needed to evaluate a cost-effective provider reminder system and additional outreach strategies directed to women who do not use health care services.
Authors: Jennifer M Polinski; Sebastian Schneeweiss; Malcolm Maclure; Blair Marshall; Samuel Ramsden; Colin Dormuth Journal: Clin Ther Date: 2011-02 Impact factor: 3.393
Authors: Judith W Dexheimer; Thomas R Talbot; David L Sanders; S Trent Rosenbloom; Dominik Aronsky Journal: J Am Med Inform Assoc Date: 2008-02-28 Impact factor: 4.497
Authors: Jan Barnsley; A Paul Williams; Janusz Kaczorowski; Eugene Vayda; Evelyn Vingilis; Alan Campbell; Karen Atkin Journal: Can Fam Physician Date: 2002-03 Impact factor: 3.275
Authors: Thomas Everett; Andrew Bryant; Michelle F Griffin; Pierre Pl Martin-Hirsch; Carol A Forbes; Ruth G Jepson Journal: Cochrane Database Syst Rev Date: 2011-05-11