Henry Ko1, Tari Turner, Christine Jones, Caron Hill. 1. Centre for Clinical Effectiveness, Southern Health, 43-51 Kanooka Grove, Clayton, VIC 3168, Australia. henry.ko@med.monash.edu.au
Abstract
OBJECTIVES: To determine whether in patients with chronic disease a patient-held medical record (PHR), compared to usual care, improves clinical care, patient outcomes or satisfaction. DESIGN: Systematic review. DATA SOURCES: Databases searched were All EBM (The Cochrane Database of Systematic Reviews, DARE CENTRAL), Medline, CINAHL and EMBASE from 1980 to 16 February 2009. STUDY SELECTION: Two reviewers assessed comparative studies that compared paper-based PHR to usual care for inclusion using a priori study selection criteria. STUDIES REVIEWED: Four hundred and eighty-one articles were reviewed by title and abstract. Full text was retrieved for 120 articles. Fourteen studies met the inclusion and exclusion criteria and were appraised using a priori criteria for methodological quality. RESULTS: Fourteen studies were included in diabetes, oncology, mental health, rheumatoid arthritis, stroke and palliative care. The studies used a variety of designs of PHR and compared this with usual care. PHR were implemented with varying degrees of patient and staff support and education, mainly for six months or less. Outcomes included attitudes on the usefulness of PHR, the quality of information exchange, process indicators, and clinical and physiological indicators. The effectiveness of PHRs is generally of low or very low quality, with the majority of studies having a high risk of bias. These studies do not demonstrate a significant benefit of introducing PHR. CONCLUSIONS: There is no clear benefit of implementing a PHR, and due to medium to high risk of bias these findings should be interpreted with caution. More high quality studies are needed to evaluate properly the effectiveness of PHRs in chronic disease populations.
OBJECTIVES: To determine whether in patients with chronic disease a patient-held medical record (PHR), compared to usual care, improves clinical care, patient outcomes or satisfaction. DESIGN: Systematic review. DATA SOURCES: Databases searched were All EBM (The Cochrane Database of Systematic Reviews, DARE CENTRAL), Medline, CINAHL and EMBASE from 1980 to 16 February 2009. STUDY SELECTION: Two reviewers assessed comparative studies that compared paper-based PHR to usual care for inclusion using a priori study selection criteria. STUDIES REVIEWED: Four hundred and eighty-one articles were reviewed by title and abstract. Full text was retrieved for 120 articles. Fourteen studies met the inclusion and exclusion criteria and were appraised using a priori criteria for methodological quality. RESULTS: Fourteen studies were included in diabetes, oncology, mental health, rheumatoid arthritis, stroke and palliative care. The studies used a variety of designs of PHR and compared this with usual care. PHR were implemented with varying degrees of patient and staff support and education, mainly for six months or less. Outcomes included attitudes on the usefulness of PHR, the quality of information exchange, process indicators, and clinical and physiological indicators. The effectiveness of PHRs is generally of low or very low quality, with the majority of studies having a high risk of bias. These studies do not demonstrate a significant benefit of introducing PHR. CONCLUSIONS: There is no clear benefit of implementing a PHR, and due to medium to high risk of bias these findings should be interpreted with caution. More high quality studies are needed to evaluate properly the effectiveness of PHRs in chronic disease populations.
Authors: Jennifer K Carroll; Jonathan N Tobin; Amneris Luque; Subrina Farah; Mechelle Sanders; Andrea Cassells; Steven M Fine; Wendi Cross; Michele Boyd; Tameir Holder; Marie Thomas; Cleo Clarize Overa; Kevin Fiscella Journal: J Gen Intern Med Date: 2019-06-25 Impact factor: 5.128
Authors: Agustín Ciapponi; Simon Lewin; Cristian A Herrera; Newton Opiyo; Tomas Pantoja; Elizabeth Paulsen; Gabriel Rada; Charles S Wiysonge; Gabriel Bastías; Lilian Dudley; Signe Flottorp; Marie-Pierre Gagnon; Sebastian Garcia Marti; Claire Glenton; Charles I Okwundu; Blanca Peñaloza; Fatima Suleman; Andrew D Oxman Journal: Cochrane Database Syst Rev Date: 2017-09-13
Authors: Sherri Adams; Eyal Cohen; Sanjay Mahant; Jeremy N Friedman; Radha Macculloch; David B Nicholas Journal: BMC Pediatr Date: 2013-01-19 Impact factor: 2.125