{"title":"A MIXED-METHODS EVALUATION OF STANDALONE PERSONAL HEALTH RECORD USE BY PATIENTS WITH TYPE 2 DIABETES.","authors":"Kevin T Fuji, Amy A Abbott, Kimberly A Galt","doi":"","DOIUrl":null,"url":null,"abstract":"<p><strong>Background: </strong>Self-management of diabetes is key for achieving positive clinical outcomes, with personal health records (PHRs) proposed as a patient-centered technology for facilitating self-care. However, few studies have described patient engagement with a PHR, including facilitators and barriers to use from the perspective of actual users.</p><p><strong>Objectives: </strong>To compare use of a standalone PHR by patients with Type 2 diabetes to usual care through assessment of self-care behaviors, and short-term impact on social cognitive outcomes and hemoglobin A1c (HbA1c).</p><p><strong>Methods: </strong>A mixed-methods design combining a comparative effectiveness pilot with qualitative interviews was used. Qualitative interviews explored the primary outcome of changes in self-care behaviors, while quantitative data obtained from health records and a survey focused on social cognitive and clinical outcomes.</p><p><strong>Results: </strong>A total of 117 participants completed the study (intervention group = 56, control group = 61). Only 23 individuals used the PHR at least once after baseline. Five themes emerged from the qualitative analysis describing participants' experiences with the PHR and identifying reasons for lack of engagement. Quantitative findings supported qualitative results with no significant changes in HbA1c and only a significant increase in diabetes knowledge in the intervention group.</p><p><strong>Conclusions: </strong>Study findings revealed low PHR uptake and minimal impact on study outcomes, including lack of communication and information-sharing between patients and providers. Future research should explore the fit of PHRs within the context of other self-management tools, integration with provider workflow, and the need for enhanced functionalities beyond an information repository to optimally support patient self-care.</p>","PeriodicalId":40052,"journal":{"name":"Perspectives in health information management / AHIMA, American Health Information Management Association","volume":null,"pages":null},"PeriodicalIF":0.0000,"publicationDate":"2021-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8649703/pdf/phim0018-0001e.pdf","citationCount":"0","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"Perspectives in health information management / AHIMA, American Health Information Management Association","FirstCategoryId":"1085","ListUrlMain":"","RegionNum":0,"RegionCategory":null,"ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"2021/1/1 0:00:00","PubModel":"eCollection","JCR":"Q3","JCRName":"Medicine","Score":null,"Total":0}
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Abstract
Background: Self-management of diabetes is key for achieving positive clinical outcomes, with personal health records (PHRs) proposed as a patient-centered technology for facilitating self-care. However, few studies have described patient engagement with a PHR, including facilitators and barriers to use from the perspective of actual users.
Objectives: To compare use of a standalone PHR by patients with Type 2 diabetes to usual care through assessment of self-care behaviors, and short-term impact on social cognitive outcomes and hemoglobin A1c (HbA1c).
Methods: A mixed-methods design combining a comparative effectiveness pilot with qualitative interviews was used. Qualitative interviews explored the primary outcome of changes in self-care behaviors, while quantitative data obtained from health records and a survey focused on social cognitive and clinical outcomes.
Results: A total of 117 participants completed the study (intervention group = 56, control group = 61). Only 23 individuals used the PHR at least once after baseline. Five themes emerged from the qualitative analysis describing participants' experiences with the PHR and identifying reasons for lack of engagement. Quantitative findings supported qualitative results with no significant changes in HbA1c and only a significant increase in diabetes knowledge in the intervention group.
Conclusions: Study findings revealed low PHR uptake and minimal impact on study outcomes, including lack of communication and information-sharing between patients and providers. Future research should explore the fit of PHRs within the context of other self-management tools, integration with provider workflow, and the need for enhanced functionalities beyond an information repository to optimally support patient self-care.
期刊介绍：
Perspectives in Health Information Management is a scholarly, peer-reviewed research journal whose mission is to advance health information management practice and to encourage interdisciplinary collaboration between HIM professionals and others in disciplines supporting the advancement of the management of health information. The primary focus is to promote the linkage of practice, education, and research and to provide contributions to the understanding or improvement of health information management processes and outcomes.
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