Saberi Parya, Catz Sheryl L, Leyden Wendy A, Stewart Christine, Ralston James D, Horberg Michael A, Grothaus Louis, Silverberg Michael J
Department of Medicine, University of California, San Francisco, San Francisco, CA, USA.
AIDS Behav. 2015 Jun;19 Suppl 2(0 2):177-85. doi: 10.1007/s10461-014-0982-x.
Electronic shared medical records (SMR) are emerging healthcare technologies that allow patients to engage in their healthcare by communicating with providers, refilling prescriptions, scheduling appointments, and viewing portions of medical records. We conducted a pre-post cohort study of HIV-positive adults who used and did not use SMR in two integrated healthcare systems. We compared the difference in antiretroviral refill adherence between SMR users and age- and sex-frequency matched non-users from the 12-month period prior to SMR useto the 12-month period starting 6 months after initiation of SMR use. High adherence was maintained among SMR users (change = -0.11 %) but declined among non-users (change = -2.05 %; p = 0.003). Among SMR users, there was a steady improvement in adherence as monthly frequency of SMR use increased (p = 0.009). SMR use, particularly more frequent use, is associated with maintaining high adherence and non-use is associated with declines in adherence over time among patients with access to these online services.
电子共享病历（SMR）是新兴的医疗技术，它使患者能够通过与医疗服务提供者沟通、重新开具处方、预约挂号以及查看部分病历等方式参与自身的医疗保健。我们在两个综合医疗系统中对使用和未使用SMR的HIV阳性成年人进行了一项前后队列研究。我们比较了SMR使用者与年龄、性别频率匹配的非使用者在开始使用SMR前12个月至开始使用SMR 6个月后12个月期间抗逆转录病毒药物重新开具的依从性差异。SMR使用者保持了较高的依从性（变化=-0.11%），而非使用者的依从性下降（变化=-2.05%；p=0.003）。在SMR使用者中，随着每月使用SMR频率的增加，依从性稳步提高（p=0.009）。对于能够使用这些在线服务的患者，使用SMR，尤其是更频繁地使用，与保持高依从性相关，而不使用则与依从性随时间下降相关。
