Abstract
BackgroundAlthough many studies have demonstrated the benefits of reminder/recall (RR) measures to address patient under-immunization and improve immunization coverage, they are not widely implemented by healthcare providers. We identified providers’ perceived barriers to their use from existing literature.MethodsWe conducted a systematic review of relevant articles published in English between January 1990 and July 2011 that examined the perceptions of healthcare providers regarding barriers to tracking patient immunization history and implementing RR interventions. We searched MEDLINE, PubMed, EMBASE, Cumulative Index to Nursing and Allied Health Literature, Academic Search Premier, and PsychINFO. Additional strategies included hand-searching the references of pertinent articles and related reviews, and searching keywords in Google Scholar and Google.ResultsTen articles were included; all described populations in the United States, and examined perceptions of family physicians, pediatricians, and other immunization staff. All articles were of moderate-high methodological quality; the majority (n=7) employed survey methodology. The most frequently described barriers involved the perceived human and financial resources associated with implementing an RR intervention, as well as low confidence in the accuracy of patient immunization records, given the lack of data sharing between multiple immunization providers. Changes to staff workflow, lack of appropriate electronic patient-tracking functionalities, and uncertainty regarding the success of RR interventions were also viewed as barriers to their adoption.ConclusionsAlthough transitioning to electronic immunization records and registries should facilitate the implementation of RR interventions, numerous perceived barriers must still be overcome before the full benefits of these methods can be realized.
Highlights
Many studies have demonstrated the benefits of reminder/recall (RR) measures to address patient under-immunization and improve immunization coverage, they are not widely implemented by healthcare providers
RR interventions can be directed at immunization providers using processes such as reminders attached by nurses or receptionists to patient charts and, with the growth of electronic medical records (EMRs) and registries, through computerized alerts [14,15]
Study scope: Our search focused on summarizing the barriers identified by immunization providers toward implementing either provider-directed RR interventions or patient-directed interventions
Summary
Many studies have demonstrated the benefits of reminder/recall (RR) measures to address patient under-immunization and improve immunization coverage, they are not widely implemented by healthcare providers. Barriers to immunization have been well-studied and include antivaccination sentiments, difficulty accessing a healthcare provider (HCP) to provide immunization, public. To address this prevalent issue, standalone and multifaceted interventions have been developed to improve vaccine coverage, both to remind individuals of upcoming immunizations and to recall those for whom immunizations are overdue. Patients who are underimmunized often do not participate in other recommended preventive care activities; immunization-based RR can improve this by providing opportunities for HCP-patient interactions [19]
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