Effectiveness of Single-Component Clinician Reminder Systems for Smoking and Obesity Preventive Care in Primary Care: A Systematic Review.

Clinician-facing reminder systems are widely used in primary care to improve preventive care delivery, but their effectiveness in managing behavioral risk factors remains uncertain. This systematic review and meta-analysis evaluated whether single-component clinician reminder systems improve smoking- and obesity-related preventive care in primary care settings. Four electronic databases were searched from inception to May 2026 for primary care studies comparing single-component clinician reminder systems with usual care. Eligible study designs included randomized controlled trials, cluster randomized controlled trials, and controlled before-and-after studies. Risk of bias was assessed using the Cochrane Risk of Bias 2 (RoB 2) tool and the Risk Of Bias In Non-randomized Studies of Interventions (ROBINS-I) tool. A random-effects meta-analysis was conducted using risk ratios with 95% confidence intervals (CIs). Four studies conducted in the United States between 1995 and 2022 were included; three examined smoking-related reminders, and one evaluated an obesity documentation prompt. Two studies were judged to have low risk of bias, one had some concerns, and one had a serious risk of bias. Individual studies generally demonstrated improvements in at least one preventive care process outcome: smoking status vital sign prompts increased physician discussion of smoking from 47% to 86% and advice to quit from 50% to 80%; routine smoking identification increased smoking cessation counseling from 53.4% to 61.9% and advice to quit from 51.5% to 59.9%; an electronic best practice alert increased quitline referrals from 0% in usual care to 9.1% in the intervention group; and adding obesity to the problem list increased documentation of obesity being addressed during follow-up from 4.6% to 14.7%. Despite these favorable individual findings, pooled analysis showed no statistically significant overall effect, with very high heterogeneity across studies. In conclusion, single-component clinician reminder systems may improve selected preventive care processes in primary care, but the overall evidence remains heterogeneous and inconclusive.