Study finds personal health records do not impact hypertension care
Research Activities, November 2012, No. 387
Personal health records (PHRs) are growing in popularity among patients who desire to maintain control over their health and well-being. These systems help patients create specific profiles of their health, prescription drugs, and visits to providers. Currently, 10 percent of the public take advantage of PHRs. However, privacy issues and access limitations remain a large concern.
In fact, a new study found that few patients with hypertension who were provided with a PHR actually used the system. Adoption of PHRs will require more education and provider intervention in order for them to have any significant impact on clinical outcomes, conclude the researchers. They examined use of PHRs in two primary care practices in which patients of 24 providers were randomized into two groups. A group of 194 patients received a PHR, while 252 patients received care as usual. All had a documented diagnosis of hypertension. Those in the intervention PHR group had access to educational materials, the ability to record and monitor blood pressure, secure messaging, and goal setting.
Among the patients offered the PHR, only 26 percent actually used the system frequently. Those who did use the PHR tended to be younger. Other factors associated with greater use included self-rated computer skills, higher Internet usage, and increased communication with providers. The researchers found no impact of the PHR on blood pressure, patient activation, the patient's perceived quality of life, or how well they used medical care. However, there was a 5.25-point reduction in diastolic blood pressure in patients using the PHR frequently.
According to the researchers, more insight is needed about who is most likely to benefit from such systems and how such information can be jointly used by patients and providers to improve outcomes. The study was supported by the Agency for Healthcare Research and Quality (HS17234).
See "Personal health records and hypertension control: A randomized trial," by Peggy J. Wagner, PhD, James Dias, PhD, Shalon Howard, M.S., and others in the July-August, 2012 Journal of the American Medical Informatics Association 19(4), pp. 626-634.