A centralized reminder system may be one way to improve childhood immunization rates, according to a new study by researchers at the University of Colorado School Of Medicine.
Past research has shown that calling parents to remind them their child needs an immunization, or calling them to tell them their child is overdue, is an effective way of increasing immunization rates. This practice is called remind/recall. But there's a problem: only 20 percent of doctor's offices actually do this. Allison Kempe, a doctor and researcher with the Children's Outcomes Research Program at the medical school, ran a trial to see if there was a better way to contact parents who needed these reminders.
The study, published online in JAMA Pediatrics, found that a centralized reminder system, run in collaboration with the Colorado's health department, was more effective than relying on a primary care practice to send reminders. This is not because reminders from primary care practices don't work, but because those practices, even when offered support, often have a hard time fitting reminder calls and mailings into their schedules, Kempe said in an interview posted on the JAMA Pediatrics site.
"If practices do reminder/recall, it works, but it's very hard for practices to do this anymore. They have so many competing demands, it takes technical knowledge, costs money," she said.
Kempe conducted the study with 18,235 children in 15 rural and urban Colorado counties. Patients were divided into two groups, one which received calls and postcards from the centralized system and the other receiving calls and cards from the primary care practices. A much higher percentage of patients in the centralized system -- 87 percent -- were contacted about immunizations, whereas just 0.8 percent of patients in the second group were contacted, because only two of the practices actually contacted their patients.
Contacting patients appeared to result in higher immunization rates as well; documentation rates for at least one immunization were 27 percent in the counties where the centralized calling system was used, versus 22 percent for the counties where practices were relied on the make the reminder calls.
With recent measles outbreaks in California and other parts of the country, ways to improve childhood immunizations are on the minds of doctors and parents across the country. Although this method does not address the problem of parents who opt out of immunizations, it can get the "low-hanging fruit" of parents who would bring their children in if they received reminders, said Kempe.
"Remind or recall is very helpful to get in parents who already want their children immunized, who have access to care, et cetera," she said.
