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予防接種率に対する患者リマインダー/リコール介入の効果: レビュー
P G Szilagyi1, C Bordley, J C Vann
1University of Rochester School of Medicine and Dentistry, Box 632, Strong Memorial Hospital, 601 Elmwood Ave, Rochester, NY 14642, USA. peter_szilagyi@urmc. rochester.edu
JAMA
|October 12, 2000
まとめ
患者リマインダーシステムは,さまざまな集団と環境で免疫率を大幅に改善します. ポストカードや電話など,これらのシステムの導入は,ワクチン接種率の向上に不可欠です.
科学分野:
- 公衆衛生は公衆衛生である.
- 予防医学は,予防的な医療です.
- 医療サービス 研究 医療サービス
背景:
- 子供と成人の予防接種率は,国家目標を下回っています.
- 医療従事者の免疫リマインダーの使用は制限されています.
- 様々な環境や集団におけるリマインダーの有効性は十分に理解されていません.
研究 の 目的:
- 免疫率の向上における患者リマインダーシステムの有効性を評価する.
- 異なる患者集団における異なるリマインダータイプの有効性を比較する.
主な方法:
- 複数のデータベースからの英語研究 (RCT,前後制御,中断されたタイムシリーズ) の体系的なレビュー.
- コクレーン・コラボレーションガイドラインによる,リマインダー/リコール・インターベンションに関する含有基準.
- 絶対パーセントポイントの変化とオッズ比率 (ORs) を用いたデータ合成,同様の研究のメタ解析.
主要な成果:
- 患者リマインダーシステムは,対象となる41の研究のうち80%で予防接種率を向上させた.
- 率の上昇は,小児および成人のワクチン接種に有効な5-20パーセントポイントの範囲であった.
- リマインダーは,学術,私立診療,公衆衛生の環境において効果的であり,電話によるリマインダーは最も効果的であった.
結論:
- 患者リマインダーシステムは,予防接種率を増やすために,プライマリケアにおいて有効です.
- プライマリケア医は,予防接種の実施を促進するために,患者のリマインダーシステムを採用すべきである.
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