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J Am Med Inform Assoc. 2014 Jul-Aug;21(4):679-86. doi: 10.1136/amiajnl-2013-002284. Epub 2013 Dec 10.

Personal health records: a randomized trial of effects on elder medication safety.

Author information

1
Department of Epidemiology, College of Public Health, The University of Iowa, Iowa City, Iowa, USA Institute for Clinical and Translational Science, The University of Iowa, Iowa City, Iowa, USA.
2
Department of Computer Science, College of Liberal Arts, The University of Iowa, Iowa City, Iowa, USA.
3
College of Pharmacy, The University of Iowa, Iowa City, Iowa, USA.
4
School of Library and Information Science, The University of Iowa, Iowa City, Iowa, USA.
5
Department of Epidemiology, College of Public Health, The University of Iowa, Iowa City, Iowa, USA.
6
Institute for Clinical and Translational Science, The University of Iowa, Iowa City, Iowa, USA.
7
College of Pharmacy, The University of Michigan, Ann Arbor, Michigan, USA.
8
Department of Epidemiology, College of Public Health, The University of Iowa, Iowa City, Iowa, USA Department of Family Medicine, Carver College of Medicine, The University of Iowa, Iowa City, Iowa, USA.

Abstract

PURPOSE:

To examine the impact of a personal health record (PHR) on medication-use safety among older adults.

BACKGROUND:

Online PHRs have potential as tools to manage health information. We know little about how to make PHRs accessible for older adults and what effects this will have.

METHODS:

A PHR was designed and pretested with older adults and tested in a 6-month randomized controlled trial. After completing mailed baseline questionnaires, eligible computer users aged 65 and over were randomized 3:1 to be given access to a PHR (n=802) or serve as a standard care control group (n=273). Follow-up questionnaires measured change from baseline medication use, medication reconciliation behaviors, and medication management problems.

RESULTS:

Older adults were interested in keeping track of their health and medication information. A majority (55.2%) logged into the PHR and used it, but only 16.1% used it frequently. At follow-up, those randomized to the PHR group were significantly less likely to use multiple non-steroidal anti-inflammatory drugs-the most common warning generated by the system (viewed by 23% of participants). Compared with low/non-users, high users reported significantly more changes in medication use and improved medication reconciliation behaviors, and recognized significantly more side effects, but there was no difference in use of inappropriate medications or adherence measures.

CONCLUSIONS:

PHRs can engage older adults for better medication self-management; however, features that motivate continued use will be needed. Longer-term studies of continued users will be required to evaluate the impact of these changes in behavior on patient health outcomes.

KEYWORDS:

Medication Management; Patient Safety; Personal Health Record

PMID:
24326536
PMCID:
PMC4078278
DOI:
10.1136/amiajnl-2013-002284
[Indexed for MEDLINE]
Free PMC Article

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