Journal article
Personal health records: a randomized trial of effects on elder medication safety
Journal of the American Medical Informatics Association : JAMIA, Vol.21(4), pp.679-686
07/2014
DOI: 10.1136/amiajnl-2013-002284
PMCID: PMC4078278
PMID: 24326536
Abstract
To examine the impact of a personal health record (PHR) on medication-use safety among older adults.
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.
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.
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.
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.
Details
- Title: Subtitle
- Personal health records: a randomized trial of effects on elder medication safety
- Creators
- Elizabeth A Chrischilles - 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, USAJuan Pablo Hourcade - Department of Computer Science, College of Liberal Arts, The University of Iowa, Iowa City, Iowa, USAWilliam Doucette - College of Pharmacy, The University of Iowa, Iowa City, Iowa, USADavid Eichmann - School of Library and Information Science, The University of Iowa, Iowa City, Iowa, USABrian Gryzlak - Department of Epidemiology, College of Public Health, The University of Iowa, Iowa City, Iowa, USARyan Lorentzen - Institute for Clinical and Translational Science, The University of Iowa, Iowa City, Iowa, USAKara Wright - Department of Epidemiology, College of Public Health, The University of Iowa, Iowa City, Iowa, USAElena Letuchy - Department of Epidemiology, College of Public Health, The University of Iowa, Iowa City, Iowa, USAMichael Mueller - Department of Epidemiology, College of Public Health, The University of Iowa, Iowa City, Iowa, USAKaren Farris - College of Pharmacy, The University of Michigan, Ann Arbor, Michigan, USABarcey Levy - 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
- Resource Type
- Journal article
- Publication Details
- Journal of the American Medical Informatics Association : JAMIA, Vol.21(4), pp.679-686
- Publisher
- England
- DOI
- 10.1136/amiajnl-2013-002284
- PMID
- 24326536
- PMCID
- PMC4078278
- ISSN
- 1527-974X
- eISSN
- 1527-974X
- Grant note
- 2 UL1 TR000442-06 / NCATS NIH HHS R18HS017034 / AHRQ HHS UL1 TR000442 / NCATS NIH HHS P30 CA086862 / NCI NIH HHS R18 HS017034 / AHRQ HHS
- Language
- English
- Date published
- 07/2014
- Academic Unit
- Pharmacy; School of Library and Information Science; Epidemiology; Family and Community Medicine; Nursing; Pharmacy Practice and Science; Computer Science
- Record Identifier
- 9983995167002771
Metrics
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