Effect of a fact sheet reminder on performance of the periodic health examination: a randomized controlled trial

Physicians' performance of the periodic health examination is often incomplete. Performance rates may be low because physicians forget recommendations for specific periodic health examination components at the time of the patient encounter. We studied the effect of providing information about seven periodic health examination actions (cervical Pap smear, mammography, fecal occult blood testing, serum cholesterol level, and influenza, pneumococcal, and diphtheria-tetanus immunizations) on first-year medical residents' performance of these actions over a three-month period. We randomly selected 16 residents to receive periodic health examination recommendations, plus data supporting each recommendation, on their outpatient charts at the patient encounter. Thirteen residents who did not receive this information served as controls. Experimental and control groups achieved similar knowledge scores (0.53 versus 0.47, P = .48) and attitude scores (0.73 versus .078, P = .19) for preventive care measures on prestudy testing. The experimental group performed 10.5% of indicated periodic health examination actions, whereas the control group performed 5.8% of indicated actions (P = NS). These results suggest no clinically meaningful improvement in performance of periodic health examination actions, even when periodic health examination guidelines were available at the time of the physician-patient encounter.