Search tips
Search criteria 


Logo of canfamphysLink to Publisher's site
Can Fam Physician. 1998 January; 44: 81–88.
PMCID: PMC2277568

Randomized controlled study of customized preventive medicine reminder letters in a community practice.


OBJECTIVE: To test the effectiveness of customized, family-oriented reminder letters in activating patients to seek appropriate preventive services. DESIGN: Randomized clinical trial. One group received computer-generated, customized letters explaining recommended preventive procedures for each family member. A second group received a form letter listing recommendations for all preventive procedures for all age and sex groups. A third group (control group) received no letters. SETTING: A private medical centre, without university affiliation, in rural Quebec. PARTICIPANTS: From 8770 patients who met study criteria, 719 families were randomly selected. Data were available for 1971 of 1998 patients in these families. MAIN OUTCOME MEASURES: The Family Received Index is the proportion of all procedures for which a family was overdue that they received. The Family End-of-study Up-to-date Index is the proportion of procedures for which the family was eligible and for which they were up-to-date at the end of the study. RESULTS: The Family Received Index for families mailed customized letters was more than double the index for patients not mailed letters (Kruskal-Wallis P = .0139). Comparison of the Family End-of-study Up-to-date indices also demonstrated that families of patients sent customized letters were more likely to be up-to-date than families not sent letters (Kruskal-Wallis P = .0054). No statistically significant difference appeared between the number of preventive measures received by the control group and the form-letter group. CONCLUSIONS: This study demonstrates a clinically small but statistically significant value to customizing reminder letters.

Full text

Full text is available as a scanned copy of the original print version. Get a printable copy (PDF file) of the complete article (1.4M), or click on a page image below to browse page by page. Links to PubMed are also available for Selected References.

Selected References

These references are in PubMed. This may not be the complete list of references from this article.
  • Olson JM. Psychological Barriers to Behavior Change: How to indentify the barriers that inhibit change. Can Fam Physician. 1992 Feb;38:309–319. [PMC free article] [PubMed]
  • Battista RN, Palmer CS, Marchand BM, Spitzer WO. Patterns of preventive practice in New Brunswick. Can Med Assoc J. 1985 May 1;132(9):1013–1015. [PMC free article] [PubMed]
  • Battista RN. Adult cancer prevention in primary care: patterns of practice in Québec. Am J Public Health. 1983 Sep;73(9):1036–1039. [PubMed]
  • Satenstein G, Lemelin J, Folkerson C, Scott KA, Hogg WE. Prevention in family practice: Consensus statement from the front line. Can Fam Physician. 1991 Oct;37:2103–2115. [PMC free article] [PubMed]
  • Frame PS, Zimmer JG, Werth PL, Martens WB. Description of a computerized health maintenance tracking system for primary care practice. Am J Prev Med. 1991 Sep-Oct;7(5):311–318. [PubMed]
  • Brownbridge G, Evans A, Wall T. Effect of computer use in the consultation on the delivery of care. Br Med J (Clin Res Ed) 1985 Sep 7;291(6496):639–642. [PMC free article] [PubMed]
  • Hutchison BG. Effect of computer-generated nurse/physician reminders on influenza immunization among seniors. Fam Med. 1989 Nov-Dec;21(6):433–437. [PubMed]
  • Rosser WW, Hutchison BG, McDowell I, Newell C. Use of reminders to increase compliance with tetanus booster vaccination. CMAJ. 1992 Mar 15;146(6):911–917. [PMC free article] [PubMed]
  • Ornstein SM, Garr DR, Jenkins RG, Rust PF, Arnon A. Computer-generated physician and patient reminders. Tools to improve population adherence to selected preventive services. J Fam Pract. 1991 Jan;32(1):82–90. [PubMed]
  • Harris RP, O'Malley MS, Fletcher SW, Knight BP. Prompting physicians for preventive procedures: a five-year study of manual and computer reminders. Am J Prev Med. 1990 May-Jun;6(3):145–152. [PubMed]
  • Wilson GA, McDonald CJ, McCabe GP., Jr The effect of immediate access to a computerized medical record on physician test ordering: a controlled clinical trial in the emergency room. Am J Public Health. 1982 Jul;72(7):698–702. [PubMed]
  • Frame PS. Can computerized reminder systems have an impact on preventive services in practice? J Gen Intern Med. 1990 Sep-Oct;5(5 Suppl):S112–S115. [PubMed]
  • Barnett GO, Winickoff RN, Morgan MM, Zielstorff RD. A computer-based monitoring system for follow-up of elevated blood pressure. Med Care. 1983 Apr;21(4):400–409. [PubMed]
  • McDowell I, Newell C, Rosser W. Comparison of three methods of recalling patients for influenza vaccination. CMAJ. 1986 Nov 1;135(9):991–997. [PMC free article] [PubMed]
  • Tierney WM, Hui SL, McDonald CJ. Delayed feedback of physician performance versus immediate reminders to perform preventive care. Effects on physician compliance. Med Care. 1986 Aug;24(8):659–666. [PubMed]
  • Rudnick KV, Sackett DL, Hirst S, Holmes C. Hypertension in a family practice. Can Med Assoc J. 1977 Sep 3;117(5):492–497. [PMC free article] [PubMed]
  • Fidler HK, Boyes DA, Worth AJ. Cervical cancer detection in British Columbia. A progress report. J Obstet Gynaecol Br Commonw. 1968 Apr;75(4):392–404. [PubMed]
  • McDowell I, Newell C, Rosser W. Comparison of three methods of recalling patients for influenza vaccination. CMAJ. 1986 Nov 1;135(9):991–997. [PMC free article] [PubMed]
  • Whiting-O'Keefe QE, Simborg DW, Epstein WV, Warger A. A computerized summary medical record system can provide more information than the standard medical record. JAMA. 1985 Sep 6;254(9):1185–1192. [PubMed]
  • Shroff KJ, Corrigan AM, Bosher M, Edmonds MP, Sacks D, Coleman DV. Cervical screening in an inner city area: response to a call system in general practice. BMJ. 1988 Nov 19;297(6659):1317–1318. [PMC free article] [PubMed]
  • Robertson AJ, Reid GS, Stoker CA, Bissett C, Waugh N, Fenton I, Rowan J, Halkerston R. Evaluation of a call programme for cervical cytology screening in women aged 50-60. BMJ. 1989 Jul 15;299(6692):163–166. [PMC free article] [PubMed]
  • Strecher VJ, Kreuter M, Den Boer DJ, Kobrin S, Hospers HJ, Skinner CS. The effects of computer-tailored smoking cessation messages in family practice settings. J Fam Pract. 1994 Sep;39(3):262–270. [PubMed]
  • Hogg WE. The family-oriented computerized medical record. MD Comput. 1992 Nov-Dec;9(6):343–345. [PubMed]
  • Hogg WE, Crouch H. Incorporating the family into a computerized office registration system. Fam Med. 1993 Feb;25(2):131–134. [PubMed]
  • Stein HF. Family Research: An Ethnographic Approach: How this approach can work for family health care. Can Fam Physician. 1991 Nov;37:2448–2528. [PMC free article] [PubMed]
  • Velicer WF, Prochaska JO, Bellis JM, DiClemente CC, Rossi JS, Fava JL, Steiger JH. An expert system intervention for smoking cessation. Addict Behav. 1993 May-Jun;18(3):269–290. [PubMed]
  • Hoffmaster Barry. Values in preventive medicine: the hidden agenda. Can Fam Physician. 1992 Feb;38:321–327. [PMC free article] [PubMed]
  • Hogg WE. A community-based practice as a research laboratory: Part 1: Why is it important? Can Fam Physician. 1991 Oct;37:2122–2126. [PMC free article] [PubMed]
  • Battista RN, Williams JI, Boucher J, Rosenberg E, Stachenko SJ, Adam J, Levinton C, Suissa S. Testing various methods of introducing health charts into medical records in family medicine units. CMAJ. 1991 Jun 1;144(11):1469–1474. [PMC free article] [PubMed]
  • Riklan M, Larson DL, Gerardi G, Beard JM. Urban hospital reaches out to its area's aged. Hospitals. 1980 May 16;54(10):110–112. [PubMed]

Articles from Canadian Family Physician are provided here courtesy of College of Family Physicians of Canada