Journal of General Internal Medicine

, Volume 4, Issue 5, pp 403–409

A controlled trial to improve delivery of preventive care

Physician or patient reminders?
  • Barbara J. Turner
  • Susan C. Day
  • Bette Borenstein
Original Articles

DOI: 10.1007/BF02599691

Cite this article as:
Turner, B.J., Day, S.C. & Borenstein, B. J Gen Intern Med (1989) 4: 403. doi:10.1007/BF02599691


Objective:To improve the delivery of preventive care in a medical clinic, a controlled trial was conducted of two interventions that were expected to influence delivery of preventive services differently, depending on level of initiative required of the physician or patient to complete a service.

Design:A prospective, controlled trial of five-months’ duration.

Setting:A university hospital-based, general medical clinic.

Participants:Thirty-nine junior and senior medical residents who saw patients in stable clinic teams throughout the study.

Intervention:A computerized reminder system for physicians and a patient questionnaire and educational handout on preventive care.

Measurements and main results:Delivery of five of six audited preventive services improved significantly after the interventions were introduced. The computerized reminder alone increased completion rates of services that relied primarily on physician initiative; the questionnaire alone increased completion rate of the service that depended more on patient compliance as well as on some physician-dependent services. Both interventions used together were slightly less effective in improving performance of physician-dependent services than the computerized reminder used alone.

Conclusions:These interventions can improve the delivery of preventive care but they differ in their impacts on physician and patient behaviors. Overall, the computer reminder was the more effective intervention.

Key words

Preventive carecomputer reminderpatient questionnairemedical clinic

Copyright information

© Society of General Internal Medicine 1989

Authors and Affiliations

  • Barbara J. Turner
    • 1
  • Susan C. Day
    • 2
  • Bette Borenstein
    • 2
  1. 1.the Department of Medicine and the Center for Research for Medical Education and Health CareThomas Jefferson University, Jefferson Medical CollegeUSA
  2. 2.the American Board of Internal Medicine and the Department of MedicineUniversity of Pennsylvania School of MedicineUSA