对个人健康记录（PHR）干预潜在敏感的状况：一项系统综述
Conditions potentially sensitive to a personal health record (PHR) intervention, a systematic review.
作者信息
Price Morgan, Bellwood Paule, Kitson Nicole, Davies Iryna, Weber Jens, Lau Francis
机构信息
Department of Family Practice, University of British Columbia, Vancouver, B.C., Canada.
Health Information Science, University of Victoria, Victoria, B.C., Canada.
出版信息
BMC Med Inform Decis Mak. 2015 Apr 18;15:32. doi: 10.1186/s12911-015-0159-1.
BACKGROUND
Personal Health Records (PHRs) are electronic health records controlled, shared or maintained by patients to support patient centered care. The potential for PHRs to transform health care is significant; however, PHRs do not always achieve their potential. One reason for this may be that not all health conditions are sensitive to the PHR as an intervention. The goal of this review was to discover which conditions were potentially sensitive to the PHR as an intervention, that is, what conditions have empirical evidence of benefit from PHR-enabled management.
METHODS
A systematic review of Medline and CINAHL was completed to find articles assessing PHR use and benefit from 2008 to 2014 in specific health conditions. Two researchers independently screened and coded articles. Health conditions with evidence of benefit from PHR use were identified from the included studies.
RESULTS
23 papers were included. Seven papers were RCTs. Ten health conditions were identified, seven of which had documented benefit associated with PHR use: asthma, diabetes, fertility, glaucoma, HIV, hyperlipidemia, and hypertension. Reported benefits were seen in terms of care quality, access, and productivity, although many benefits were measured by self-report through quasi-experimental studies. No study examined morbidity/mortality. No study reported harm from the PHR.
CONCLUSION
There is a small body of condition specific evidence that has been published. Conditions with evidence of benefit when using PHRs tended to be chronic conditions with a feedback loop between monitoring in the PHR and direct behaviours that could be self-managed. These findings can point to other potentially PHR sensitive health conditions and guide PHR designers, implementers, and researchers. More research is needed to link PHR design, features, adoption and health outcomes to better understand how and if PHRs are making a difference to health outcomes.
背景
个人健康记录（PHR）是由患者控制、共享或维护的电子健康记录，以支持以患者为中心的医疗服务。PHR改变医疗保健的潜力巨大；然而，PHR并不总能发挥其潜力。原因之一可能是并非所有健康状况对PHR这种干预措施都敏感。本综述的目的是发现哪些状况可能对PHR这种干预措施敏感，即哪些状况有实证证据表明通过启用PHR的管理能从中受益。
方法
完成了对Medline和CINAHL的系统综述，以查找2008年至2014年期间评估在特定健康状况下使用PHR及其益处的文章。两名研究人员独立筛选并对文章进行编码。从纳入的研究中确定有证据表明使用PHR有益的健康状况。
结果
纳入了23篇论文。其中7篇为随机对照试验。确定了10种健康状况，其中7种有记录表明使用PHR有益：哮喘、糖尿病、生育、青光眼、艾滋病毒感染、高脂血症和高血压。在护理质量、可及性和生产力方面都有报告称有益处，不过许多益处是通过准实验研究中的自我报告来衡量的。没有研究考察发病率/死亡率。没有研究报告PHR造成的危害。
结论
已发表了一小部分针对特定状况的证据。使用PHR时有证据表明有益的状况往往是慢性病，在PHR中的监测与可自我管理的直接行为之间存在反馈回路。这些发现可以指向其他可能对PHR敏感的健康状况，并指导PHR的设计者、实施者和研究人员。需要更多研究来将PHR的设计、功能、采用情况与健康结果联系起来，以更好地理解PHR如何以及是否对健康结果产生影响。
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