VA QUERI Program and VA New England Healthcare System, Bedford VA Medical Center, 200 Springs Road, Building 70, Bedford, MA, 01730, USA,
AIDS Behav. 2013 Nov;17(9):3091-100. doi: 10.1007/s10461-012-0399-3.
Patient electronic personal health record (PHR) use has been associated with improved patient outcomes in diabetes and depression care. Little is known about the effect of PHR use on HIV care processes and outcomes. We evaluated whether there was an association between patient PHR use and antiretroviral adherence. Data came from the Veterans Aging Cohort Study and included cross-sectional survey and medical record data from 1871 HIV+ veterans. Our adherence measure was an antiretroviral medication possession ratio, dichotomized at 0.90, and based on pharmacy refill data. In our sample 44 % did not use the internet, 14 % used internet but not for health, 27 % used internet for health but not the PHR, and 14 % used the PHR. In multivariable analysis PHR use was associated with ≥90 % adherence after controlling for socio-demographic variables. Findings provide support for longitudinal studies and studies that identify which PHR functions (e.g. online medication refills, viewing lab results, secure messaging with providers) are most closely associated with medication adherence.
患者电子个人健康记录(PHR)的使用与糖尿病和抑郁症治疗中患者预后的改善有关。但对于 PHR 使用对 HIV 护理流程和结果的影响知之甚少。我们评估了患者 PHR 使用与抗逆转录病毒药物依从性之间是否存在关联。数据来自退伍军人老龄化队列研究,包括 1871 名 HIV+退伍军人的横断面调查和医疗记录数据。我们的依从性衡量标准是抗逆转录病毒药物药物维持率,根据药物补充数据分为 0.90,并将其分为两部分。在我们的样本中,44%的人不上网,14%的人上网但不是为了健康,27%的人上网是为了健康但不是为了 PHR,14%的人使用 PHR。在多变量分析中,在控制了社会人口统计学变量后,PHR 使用与≥90%的依从性相关。研究结果为纵向研究和确定哪些 PHR 功能(例如在线药物补充、查看实验室结果、与提供者进行安全消息传递)与药物依从性最密切相关的研究提供了支持。