Document Detail

Personal health records and hypertension control: a randomized trial.
MedLine Citation:
PMID:  22234404     Owner:  NLM     Status:  MEDLINE    
PURPOSE: 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.
METHODS: 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.
RESULTS: 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.
CONCLUSIONS: 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.
Peggy J Wagner; James Dias; Shalon Howard; Kristina W Kintziger; Matthew F Hudson; Yoon-Ho Seol; Pat Sodomka
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Publication Detail:
Type:  Journal Article; Multicenter Study; Randomized Controlled Trial; Research Support, U.S. Gov't, P.H.S.     Date:  2012-01-10
Journal Detail:
Title:  Journal of the American Medical Informatics Association : JAMIA     Volume:  19     ISSN:  1527-974X     ISO Abbreviation:  J Am Med Inform Assoc     Publication Date:    2012 Jul-Aug
Date Detail:
Created Date:  2012-07-23     Completed Date:  2012-12-20     Revised Date:  2013-07-02    
Medline Journal Info:
Nlm Unique ID:  9430800     Medline TA:  J Am Med Inform Assoc     Country:  United States    
Other Details:
Languages:  eng     Pagination:  626-34     Citation Subset:  IM    
School of Medicine, Department of Family Medicine, Georgia Health Sciences University, Augusta, Georgia, USA.
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MeSH Terms
Attitude to Health
Electronic Health Records* / utilization
Health Records, Personal*
Hypertension / therapy*
Intention to Treat Analysis
Middle Aged
Outcome Assessment (Health Care)*
Patient-Centered Care
Power (Psychology)
Prospective Studies
Quality of Health Care
Self Care*
United States
Grant Support
R18 HS017234/HS/AHRQ HHS

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine

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