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Arch Intern Med. 2008 Sep 8;168(16):1776-82. doi: 10.1001/archinte.168.16.1776.

Practice-linked online personal health records for type 2 diabetes mellitus: a randomized controlled trial.

Author information

1
Division of General Medicine, Massachusetts General Hospital, 50-9 Staniford St, Boston, Massachusetts 02114, USA. Rgrant@partners.org

Abstract

BACKGROUND:

Web-based personal health records (PHRs) have been advocated as a means to improve type 2 diabetes mellitus (DM) care. However, few Web-based systems are linked directly to the electronic medical record (EMR) used by physicians.

METHODS:

We randomized 11 primary care practices. Intervention practices received access to a DM-specific PHR that imported clinical and medications data, provided patient-tailored decision support, and enabled the patient to author a "Diabetes Care Plan" for electronic submission to their physician prior to upcoming appointments. Active control practices received a PHR to update and submit family history and health maintenance information. All patients attending these practices were encouraged to sign up for online access.

RESULTS:

We enrolled 244 patients with DM (37% of the eligible population with registered online access, 4% of the overall population of patients with DM). Study participants were younger (mean age, 56.1 years vs 60.3 years; P < .001) and lived in higher-income neighborhoods (median income, $53,784 vs $49,713; P < .001) but had similar baseline glycemic control compared with nonparticipants. More patients in the intervention arm had their DM treatment regimens adjusted (53% vs 15%; P < .001) compared with active controls. However, there were no significant differences in risk factor control between study arms after 1 year (P = .53).

CONCLUSIONS:

Previsit use of online PHR linked to the EMR increased rates of DM-related medication adjustment. Low rates of online patient account registration and good baseline control among participants limited the intervention's impact on overall risk factor control.

TRIAL REGISTRATION:

clinicaltrials.gov Identifier: NCT00251875.

PMID:
18779465
PMCID:
PMC3829635
DOI:
10.1001/archinte.168.16.1776
[Indexed for MEDLINE]
Free PMC Article

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