Computer-generated physician and patient reminders. Tools to improve population adherence to selected preventive services.

Despite an emerging consensus on appropriate preventive services- a minority of patients receive them. A study was undertaken to assess the impact of computer-generated reminders to adult patients- their physicians- or both patients and physicians on adherence to five recommended preventive services: cholesterol measurements- fecal occult blood testing- mammography- Papanicolaou smears- and tetanus immunization. During the academic year 1988-1989- all 7397 adult patients and their 49 physicians in a university family medicine clinical practice were randomized by practice group into one of four study groups: control- physician reminders- patient reminders- and both physician and patient reminders. Adherence was defined in community-oriented terms: the percentage of patients within each group who had received the preventive service in the recommended interval. During the study period- adherence to four of the five preventive services increased significantly- with the largest increases in the physician and patie