Personal health records and hypertension control: A randomized trial

School of Medicine, Department of Family Medicine, Georgia Health Sciences University, Augusta, Georgia, USA.
Journal of the American Medical Informatics Association (Impact Factor: 3.5). 01/2012; 19(4):626-34. DOI: 10.1136/amiajnl-2011-000349
Source: PubMed


To examine the impact of a personal health record (PHR) in patients with hypertension measured by changes in biological outcomes, patient empowerment, patient perception of quality of care, and use of medical services.
A cluster-randomized effectiveness trial with PHR and no PHR groups was conducted in two ambulatory clinics. 453 of 1686 (26.4%) patients approached were included in the analyses. A PHR tethered to the patient's electronic medical record (EMR) was the primary intervention and included security measures, patient control of access, limited transmission of EMR data, blood pressure (BP) tracking, and appointment assistance. BP was the main outcome measure. Patient empowerment was assessed using the Patient Activation Measure and Patient Empowerment Scale. Quality of care was assessed using the Clinician and Group Assessment Score (CAHPS) and the Patient Assessment of Chronic Illness Care. Frequency of use of medical services was self-reported.
No impact of the PHR was observed on BP, patient activation, patient perceived quality, or medical utilization in the intention-to-treat analysis. Sub-analysis of intervention patients self-identified as active PHR users (25.7% of those with available information) showed a 5.25-point reduction in diastolic BP. Younger age, self-reported computer skills, and more positive provider communication ratings were associated with frequency of PHR use.
Few patients provided with a PHR actually used the PHR with any frequency. Thus simply providing a PHR may have limited impact on patient BP, empowerment, satisfaction with care, or use of health services without additional education or clinical intervention designed to increase PHR use. Identifier: NCT01317537.

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Available from: Kristina W Kintziger, Sep 03, 2015
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    • "Given the limited number of studies that met the inclusion criteria for this review, we conducted a qualitative secondary analysis of 11 additional trials [14,42-51] that met all of the inclusion criteria with one exception: the measure of patient engagement lacked one of the three key a priori components (data not shown). Specifically, seven studies [14,43,46-50] (63.6%) did not measure knowledge, one study did not measure confidence [42] (9.1%), and three studies [44,45,51] (27.3%) did not measure any health behaviors; six [43,44,47,48,50,51] of these studies (54.5%) were of high quality. We described these studies according to the same data fields as described in the primary analyses above. "
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