scholarly journals Important Design Features of Personal Health Records to Improve Medication Adherence for Patients with Long-Term Conditions: Protocol for a Systematic Literature Review (Preprint)

2018 ◽  
Author(s):  
Elisavet Andrikopoulou ◽  
Philip James Scott ◽  
Helena Herrera
Keyword(s):  
Medication Adherence ◽  
Literature Review ◽  
Systematic Literature Review ◽  
Personal Health Records ◽  
Personal Health ◽  
Improve Medication Adherence ◽  
Long Term Conditions ◽  
Health Records ◽  
Important Design

BACKGROUND The National Health Service (NHS) England spent £15.5 billion on medication in 2015. More than a third of patients affected by at least one long-term condition do not adhere to their drug regime. Many interventions have been trialed to improve medication adherence. One promising innovation is the electronic personal health record. OBJECTIVE This systematic literature review aims to identify the important design features of personal health records to improve medication adherence for patients with long-term conditions. METHODS This protocol follows the Preferred Reporting Items for Systematic Reviews and Meta-Analyses Protocol (PRISMA-P 2015) statement. The following databases will be searched for relevant articles: PubMed, Science Direct, BioMed Central, Cumulative Index to Nursing and Allied Health Literature, Cochrane Database of Systematic Reviews, and the Cochrane Central Register of Controlled Trials. Studies published in the last fifteen years, in English, will be included if the participants are adults who were treated outside the hospital, have the ability to self-administer their medication, and have at least one long-term condition. The review will exclude commercial or political sources and papers without references. Papers that research pediatrics, pregnant, or terminally ill patients will also be excluded, since their medication management is typically more complex. RESULTS One reviewer will screen the included studies, extract the relevant data, and assess the quality of evidence utilizing the Grading of Recommendations Assessment, Development, and Evaluation system and the risk of bias using the Cochrane RevMan tool. The second reviewer will assess the quality of 25% of the included studies to assess interrater agreement. Any disagreement will be solved by a third reviewer. Only studies of high and moderate quality will be included for narrative synthesis. CONCLUSIONS NHS policy assumes that increasing usage of personal health records by citizens will reduce demand on health care services. There is limited evidence, however, that the use of health apps can improve patient outcomes, and, to our knowledge, this is the first systematic literature review aiming to identify important design features of the personal health record which may improve medication adherence in the adult population with long-term conditions. CLINICALTRIAL PROSPERO CRD42017060542; https://www.crd.york.ac.uk/prospero/display_record.php?RecordID=60542 (Archived by WebCite at http://www.webcitation.org/6zeuWXxVh) REGISTERED REPORT IDENTIFIER RR1-10.2196/9778

scholarly journals What are the important design features of personal health records to improve medication adherence for patients with long-term conditions? A systematic literature review

BMJ Open ◽  
2019 ◽  
Vol 9 (9) ◽  
pp. e028628 ◽  
Author(s):  
Elisavet Andrikopoulou ◽  
Philip Scott ◽  
Helena Herrera ◽  
Alice Good
Keyword(s):  
Medication Adherence ◽  
Risk Of Bias ◽  
Personal Health ◽  
Design Features ◽  
Improve Medication Adherence ◽  
Long Term Conditions ◽  
Quality Of Evidence ◽  
Important Design

ObjectivesThis systematic literature review aims to identify important design features of the electronic personal health record (PHR) that may improve medication adherence in the adult population with long-term conditions.Data sourcesPubMed (including MEDLINE), CINAHL, Science Direct (including EMBASE), BioMed Central, ACM digital, Emerald Insight, Google Scholar and Research Gate.MethodsStudies that were published between 1 January 2002 and 31 May 2018 in English were included if the participants were adults, with at least one long-term condition, were able to self-administer their medication and were treated in primary care settings. The quality of evidence was assessed with the Grading of Recommendations Assessment, Development, and Evaluation (GRADE) system and the risk of bias was appraised using the Cochrane risk of bias tool.ResultsFrom a total of 27 studies that matched the inclusion criteria, 12 were excluded due to low quality of evidence, 10 were rated moderate and 5 were rated high quality. All the included studies had low sample size and limited follow-up duration. Thirteen of the included studies found that the use of a PHR has increased medication adherence. The identified design features are reminders, education, personalisation and tailoring, feedback and alerts, gamification, medication management, medical appointment management, diary and self-monitoring, health condition management, set goals, patient’s blog and tethered. It was impossible to draw conclusions as to which feature is important to what group of patients and why. The most frequently identified conditions were HIV and diabetes. This review did not identify any papers with negative results. It was not possible to numerically aggregate the PHR effect due to high heterogeneity of the medication adherence measurement, study type, participants and PHRs used.ConclusionAlthough we found recurrent evidence that PHRs can improve medication adherence, there is little evidence to date to indicate which design features facilitate this process.PROSPERO registration numberCRD42017060542.

scholarly journals Mixed methods protocol for a realist evaluation of electronic personal health records design features and use to support medication adherence (ePHRma)

2020 ◽  
Vol 27 (1) ◽  
pp. e100046
Author(s):  
Elisavet Andrikopoulou ◽  
Philip J Scott ◽  
Helena Herrera
Keyword(s):  
Mixed Methods ◽  
Medication Adherence ◽  
Data Collection ◽  
Short Form ◽  
Realist Evaluation ◽  
Personal Health Records ◽  
Personal Health ◽  
Long Term Conditions ◽  
Health Records ◽  
Electronic Personal Health Records

BackgroundNational Health Service policy suggests that increasing usage of electronic personal health records (PHR) by patients will result in cost savings and improved public health. Medication adherence means that patients take their prescribed medication as agreed with their doctors. Some of the claimed benefits of PHRs are decreasing healthcare costs and improving medication adherence and patient outcomes.MethodsThis is a mixed methods convergent study, primarily qualitative. The qualitative and quantitative data collection and analysis will occur in parallel, and then be synthesised. We are interviewing and surveying adults with long-term conditions to identify what are the most important and useful features of their current PHR. The data collection comprises patient demographics, the Medication Adherence Questionnaire, the personality scale Big Five Inventory-2 Extra-Short Form and the WHO Quality of Life-BREF scale. Qualitative data will be analysed using the Framework method.EthicsWe have received a favourable ethical opinion from the Health Research Authority/Research Ethics Committee.

scholarly journals Personal Health Records: A Systematic Literature Review

2017 ◽  
Vol 19 (1) ◽  
pp. e13 ◽  
Author(s):  
Alex Roehrs ◽  
Cristiano André da Costa ◽  
Rodrigo da Rosa Righi ◽  
Kleinner Silva Farias de Oliveira
Keyword(s):  
Literature Review ◽  
Systematic Literature Review ◽  
Personal Health Records ◽  
Personal Health ◽  
Health Records

scholarly journals Methods to improve medication adherence in patients with chronic inflammatory rheumatic diseases: a systematic literature review

RMD Open ◽  
2018 ◽  
Vol 4 (2) ◽  
pp. e000684 ◽  
Author(s):  
Matthieu Lavielle ◽  
Déborah Puyraimond-Zemmour ◽  
Xavier Romand ◽  
Laure Gossec ◽  
Eric Senbel ◽  
...  
Keyword(s):  
Medication Adherence ◽  
Literature Review ◽  
Rheumatic Diseases ◽  
Systematic Literature Review ◽  
Lupus Erythematosus ◽  
Connective Tissue Diseases ◽  
Educational Interventions ◽  
Inflammatory Rheumatic Diseases ◽  
Improve Medication Adherence ◽  
Chronic Inflammatory Rheumatic Diseases

ObjectiveLack of adherence to treatment is frequent in chronic inflammatory rheumatic diseases and is associated with poorer outcomes. The objective of this study was to describe and evaluate interventions that have been proposed to enhance medication adherence in these conditions.MethodsA systematic literature review was performed in Pubmed, Cochrane, Embase and clinicaltrials.gov databases completed by the rheumatology meeting (ACR, EULAR and SFR) abstracts from last 2 years. All studies in English or French evaluating an intervention to improve medication adherence in chronic inflammatory rheumatic diseases (rheumatoid arthritis (RA), spondyloarthritis (SpA), crystal related diseases, connective tissue diseases, vasculitis and Still’s disease) were included. Interventions on adherence were collected and classified in five modalities (educational, behavioural, cognitive behavioural, multicomponent interventions or others).Results1325 abstracts were identified and 22 studies were finally included (18 studies in RA (72%), 4 studies in systemic lupus erythematosus (16%), 2 studies in SpA (8%) and 1 study in gout (4%)). On 13 randomised controlled trials (RCT) (1535 patients), only 5 were positive (774 patients). Educational interventions were the most represented and had the highest level of evidence: 8/13 RCT (62%, 1017 patients) and 4/8 were positive (50%). In these studies, each patient was individually informed or educated by different actors (physicians, pharmacists, nurses and so on). Supports and contents of these educational interventions were heterogenous.ConclusionDespite the importance of medication adherence in chronic inflammatory rheumatic disorders, evidence on interventions to improve medication adherence is scarce.

Medication Adherence in Older Patients With Dementia: A Systematic Literature Review

2017 ◽  
Vol 31 (3) ◽  
pp. 322-334 ◽  
Author(s):  
Najwan El-Saifi ◽  
Wendy Moyle ◽  
Cindy Jones ◽  
Haitham Tuffaha
Keyword(s):  
Medication Adherence ◽  
Literature Review ◽  
Systematic Literature Review ◽  
Older Patients ◽  
Cochrane Library ◽  
Future Research ◽  
Improve Medication Adherence ◽  
Related Factors ◽  
Medication Discontinuation ◽  
Increased Risk

Background: Older patients with dementia are often unable to take their medications as prescribed due to cognitive and physical impairment. Objectives: To review the evidence on medication adherence in older patients with dementia in terms of the level of adherence, outcomes, contributing factors, and available interventions. Methods: A systematic literature review was performed following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. Searched databases included CINAHL, Cochrane Library, DARE, MEDLINE, and PubMed. Results: Eighteen studies reported levels of medication adherence or discontinuation and related factors. Medication adherence ranged from 17% to 42%, and medication discontinuation before the end of treatment ranged from 37% to 80%. Nonadherence was associated with an increased risk of hospitalization or death, while increasing age, choice of medication, use of concomitant medications, and medicines’ costs were reported to decrease medication adherence. Telehealth home monitoring and treatment modification were the only interventions reported in the literature to improve medication adherence in this population. Conclusion: Older patients with dementia have a low level of medication adherence. Future research should focus on the development and implementation of interventions to help older patients with dementia and their caregivers make better use of medications.

scholarly journals A Review of the Empirical Evidence of the Healthcare Benefits of Personal Health Records

2013 ◽  
Vol 22 (01) ◽  
pp. 93-102
Author(s):  
B. Fernando ◽  
D. Kalra
Keyword(s):  
Health Care ◽  
Literature Review ◽  
User Acceptance ◽  
Personal Health Records ◽  
Personal Health ◽  
Institute Of Medicine ◽  
Health Records ◽  
Electronic Personal Health Records ◽  
Definition Of ◽  
Abstract Screening

Summary Objectives: This literature review sought to identify the established evidence of the health and healthcare benefits (or harms) from the use of electronic personal health records (PHRs) and PHR systems. Methods: The definition of a PHR published in ISO 14292 was used to scope this review and the search strategy. Publications were included if the introduction of a PHR was the primary intervention, and if its evaluation met one of the Cochrane EPOC Group criteria. Studies were excluded if they only reported the design or basic user acceptance of a PHR system without an assessment of its impact on individuals and/or their health care. The impacts were classified according to the six aims of 21st-century health care defined by the US Institute of Medicine. Results: Searches were conducted in PubMed in December 2012. Out of 741 papers that met our initial search criteria, 31 were retained after title and abstract screening. After full paper review 5 studies were found to report original evidence of impact. Of these, three reported beneficial impacts on effectiveness, one on patient centredness, and one study reported impact on both aims. No harmful effects were reported. Conclusions: Although this literature review did identify some evidenced benefits from the use of PHRs and systems, our main observation is that there are very few studies published that seek to formally evaluate impact. The majority of publications we screened documented designs or basic user acceptance. Further investment in evaluation is needed to inform the evolution of this field.

Building Better E-Health Through a Personal Health Informatics Pedagogy

2011 ◽  
pp. 342-349
Author(s):  
E. Vance Wilson
Keyword(s):  
Health Services ◽  
Health Informatics ◽  
Personal Health Records ◽  
Consumer Health Informatics ◽  
Personal Health ◽  
User Needs ◽  
Consumer Health ◽  
Health Records ◽  
Pedagogical Framework

E-health use is increasing worldwide, but no current e-health paradigm fulfills the complete range of user needs for online health services. This dilemma clouds a number of issues surrounding e-health, as promoters of e-commerce, personal health records, and consumer health informatics paradigms attempt to create encompassing e-health within the constraints of each unique perspective. In the long term, the most important of these issues may be the need to develop an e-health pedagogy that offers conceptual grounding and course curricula in order to effectively represent all facets of e-health. To address that issue, this article introduces a personal health informatics (PHI) paradigm that incorporates the best features of preceding paradigms by integrating informatics, personal, and healthcare perspectives. Drawing from PHI, a pedagogical framework is proposed to guide instruction in the design and development of encompassing e-health.

Sign in / Sign up

Export Citation Format

Share Document