Personal health records and hypertension control: A randomized trial

Peggy J. Wagner, James Dias, Shalon Howard, Kristina W. Kintziger, Matthew F. Hudson, Yoonho Seol, Pat Sodomka

Research output: Contribution to journalArticle

65 Citations (Scopus)

Abstract

Purpose To examine the impact of a personal health record (PHR) in patients with hypertension measured by changes in biological outcomes, patient empowerment, patient perception of quality of care, and use of medical services. Methods A cluster-randomized effectiveness trial with PHR and no PHR groups was conducted in two ambulatory clinics. 453 of 1686 (26.4%) patients approached were included in the analyses. A PHR tethered to the patient's electronic medical record (EMR) was the primary intervention and included security measures, patient control of access, limited transmission of EMR data, blood pressure (BP) tracking, and appointment assistance. BP was the main outcome measure. Patient empowerment was assessed using the Patient Activation Measure and Patient Empowerment Scale. Quality of care was assessed using the Clinician and Group Assessment Score (CAHPS) and the Patient Assessment of Chronic Illness Care. Frequency of use of medical services was self-reported. Results No impact of the PHR was observed on BP, patient activation, patient perceived quality, or medical utilization in the intention-to-treat analysis. Sub-analysis of intervention patients self-identified as active PHR users (25.7% of those with available information) showed a 5.25-point reduction in diastolic BP. Younger age, self-reported computer skills, and more positive provider communication ratings were associated with frequency of PHR use. Conclusions Few patients provided with a PHR actually used the PHR with any frequency. Thus simply providing a PHR may have limited impact on patient BP, empowerment, satisfaction with care, or use of health services without additional education or clinical intervention designed to increase PHR use. Clinical trial registration number http://ClinicalTrials.gov Identifier: NCT01317537.

Original languageEnglish (US)
Pages (from-to)626-634
Number of pages9
JournalJournal of the American Medical Informatics Association
Volume19
Issue number4
DOIs
StatePublished - Jul 1 2012

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Personal Health Records
Hypertension
Patient Participation
Blood Pressure
Electronic Health Records
Quality of Health Care
Security Measures
Intention to Treat Analysis
Health Services
Appointments and Schedules
Chronic Disease

ASJC Scopus subject areas

  • Health Informatics

Cite this

Personal health records and hypertension control : A randomized trial. / Wagner, Peggy J.; Dias, James; Howard, Shalon; Kintziger, Kristina W.; Hudson, Matthew F.; Seol, Yoonho; Sodomka, Pat.

In: Journal of the American Medical Informatics Association, Vol. 19, No. 4, 01.07.2012, p. 626-634.

Research output: Contribution to journalArticle

Wagner, Peggy J. ; Dias, James ; Howard, Shalon ; Kintziger, Kristina W. ; Hudson, Matthew F. ; Seol, Yoonho ; Sodomka, Pat. / Personal health records and hypertension control : A randomized trial. In: Journal of the American Medical Informatics Association. 2012 ; Vol. 19, No. 4. pp. 626-634.
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abstract = "Purpose To examine the impact of a personal health record (PHR) in patients with hypertension measured by changes in biological outcomes, patient empowerment, patient perception of quality of care, and use of medical services. Methods A cluster-randomized effectiveness trial with PHR and no PHR groups was conducted in two ambulatory clinics. 453 of 1686 (26.4{\%}) patients approached were included in the analyses. A PHR tethered to the patient's electronic medical record (EMR) was the primary intervention and included security measures, patient control of access, limited transmission of EMR data, blood pressure (BP) tracking, and appointment assistance. BP was the main outcome measure. Patient empowerment was assessed using the Patient Activation Measure and Patient Empowerment Scale. Quality of care was assessed using the Clinician and Group Assessment Score (CAHPS) and the Patient Assessment of Chronic Illness Care. Frequency of use of medical services was self-reported. Results No impact of the PHR was observed on BP, patient activation, patient perceived quality, or medical utilization in the intention-to-treat analysis. Sub-analysis of intervention patients self-identified as active PHR users (25.7{\%} of those with available information) showed a 5.25-point reduction in diastolic BP. Younger age, self-reported computer skills, and more positive provider communication ratings were associated with frequency of PHR use. Conclusions Few patients provided with a PHR actually used the PHR with any frequency. Thus simply providing a PHR may have limited impact on patient BP, empowerment, satisfaction with care, or use of health services without additional education or clinical intervention designed to increase PHR use. Clinical trial registration number http://ClinicalTrials.gov Identifier: NCT01317537.",
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