van Vugt M, de Wit M, Sieverink F, Roelofsen Y, Hendriks S H, Bilo H J G, Snoek F J
Department of Medical Psychology, VU University Medical Center, 1081 HZ Amsterdam, Netherlands; EMGO Institute for Health and Care Research, VU University Medical Center, 1081 HZ Amsterdam, Netherlands.
Centre for eHealth and Wellbeing Research, University of Twente, 7522 NB Enschede, Netherlands.
J Diabetes Res. 2016;2016:5027356. doi: 10.1155/2016/5027356. Epub 2016 Feb 3.
We studied the use, uptake, and effects of e-Vita, a personal health record, with self-management support and personalized asynchronized coaching, for type 2 diabetes patients treated in primary care. Patients were invited by their practice nurse to join the study aimed at testing use and effects of a personal health record. Patients were followed up for 6 months. Uptake and usage were monitored using log data. Outcomes were self-reported diabetes self-care, diabetes-related distress, and emotional wellbeing. Patients' health status was collected from their medical chart. 132 patients agreed to participate in the study of which less than half (46.1%) did not return to the personal health record after 1st login. Only 5 patients used the self-management support program within the personal health record, 3 of whom asked a coach for feedback. Low use of the personal health record was registered. No statistical significant differences on any of the outcome measures were found between baseline and 6 month follow-up. This study showed minimal impact of implementing a personal health record including self-management support in primary diabetes care. Successful adoption of web-based platforms, as ongoing patient centered care, is hard to achieve without additional strategies aimed at enhancing patient motivation and engaging professionals.
我们研究了电子健康记录e-Vita在初级护理中对2型糖尿病患者的使用情况、接受程度及其效果,该记录具备自我管理支持和个性化异步指导功能。患者由其执业护士邀请加入旨在测试个人健康记录的使用情况及效果的研究。对患者进行了6个月的随访。使用日志数据监测接受程度和使用情况。结果包括自我报告的糖尿病自我护理、糖尿病相关困扰和情绪健康状况。患者的健康状况从其病历中收集。132名患者同意参与研究,其中不到一半(46.1%)在首次登录后未再使用个人健康记录。只有5名患者使用了个人健康记录中的自我管理支持计划,其中3人向指导人员寻求反馈。个人健康记录的使用情况较低。在基线和6个月随访之间,在任何结果指标上均未发现统计学上的显著差异。本研究表明,在初级糖尿病护理中实施包括自我管理支持在内的个人健康记录影响甚微。如果没有旨在提高患者积极性和促使专业人员参与的额外策略,作为持续的以患者为中心的护理方式,成功采用基于网络的平台是很难实现的。