Institute of Applied Health Research, College of Medical and Dental Sciences, University of Birmingham, Edgbaston, Birmingham, United Kingdom.
Amrita Institute of Medical Sciences and Research Centre, Cochin, India.
PLoS One. 2022 Aug 4;17(8):e0267192. doi: 10.1371/journal.pone.0267192. eCollection 2022.
Evidence shows that a gap in the documentation of patients' past medical history leads to errors in, or duplication of, treatment and is a threat to patient safety. Home-based or patient-held records (HBR) are widely used in low and middle-income countries (LMIC) in maternal and childcare. The aim is to systematically review the evidence on HBRs in LMICs for (1) improving informational continuity for providers and women/families across health care visits and facilities, (2) to describe the perceived usefulness by women/families and healthcare providers, and (3) maternal and child health outcomes of using HBRs for maternal and child health care.
The protocol was registered in PROSPERO (CRD42019139365). We searched MEDLINE, EMBASE, CINAHL, and Global Index Medicus databases for studies with home-based records from LMICs. Search terms pertained to women or parent-held records and LMICs. Two reviewers assessed studies for inclusion using a priori study selection criteria- studies explaining the use of HBRs in LMIC for maternal and child health care. The included study quality was appraised using the Mixed Methods Appraisal Tool (MMAT). Results from all study designs were summarised narratively.
In total, 41 papers were included in the review from 4514 potential studies. Included studies represented various study designs and 16 countries. The least evaluated function of HBR was information continuity across health care facilities (n = 6). Overall, there were limited data on the usefulness of HBRs to providers and mothers/families. Home-based records were mostly available for providers during health care visits. However, the documentation in HBRs varied. The use of HBRs is likely to lead to improved antenatal visits and immunisation uptake, and skilled birth delivery in some settings. Mothers' knowledge of breastfeeding practices and danger signs in pregnancy improved with the use of HBRs. One randomised trial found the use of HBRs reduced the risk of cognitive development delay in children and another reported on trial lessened the risk of underweight and stunted growth in children.
There is limited literature from LMICs on the usefulness of HBRs and for improving information transfer across healthcare facilities, or their use by women at home. Current HBRs from LMICs are sub-optimally documented leading to poor informational availability that defeats the point of them as a source of information for future providers.
有证据表明，患者既往病史记录不完整会导致治疗错误或重复，从而威胁患者安全。家庭或患者持有的记录（HBR）在中低收入国家（LMIC）的母婴保健中被广泛使用。其目的是系统地审查关于 LMIC 中 HBR 的证据，（1）改善提供者和女性/家庭在就诊和医疗机构之间的信息连续性，（2）描述女性/家庭和医疗保健提供者对 HBR 的感知有用性，以及（3）使用 HBR 进行母婴保健的母婴健康结果。
该方案在 PROSPERO（CRD42019139365）中进行了注册。我们在 MEDLINE、EMBASE、CINAHL 和全球索引医学数据库中搜索了来自 LMIC 的家庭记录的研究。检索词涉及女性或父母持有的记录和 LMIC。两名审查员使用事先确定的研究选择标准评估了纳入研究-解释 HBR 在 LMIC 中用于母婴保健的研究。使用混合方法评估工具（MMAT）评估纳入研究的质量。所有研究设计的结果均以叙述方式进行总结。
从 4514 项潜在研究中，共有 41 篇论文纳入综述。纳入的研究代表了各种研究设计和 16 个国家。HBR 在医疗保健机构之间信息连续性方面的评估最少（n=6）。总体而言，关于 HBR 对提供者和母亲/家庭有用性的数据有限。家庭记录在就诊期间主要提供给提供者。然而，HBR 中的记录各不相同。在某些情况下，HBR 的使用可能会导致产前检查、免疫接种率提高和熟练分娩。使用 HBR 可提高母亲对母乳喂养实践和妊娠危险信号的认识。一项随机试验发现，使用 HBR 可降低儿童认知发育迟缓的风险，另一项试验报告称，使用 HBR 可降低儿童体重不足和发育迟缓的风险。
关于 HBR 的有用性以及改善医疗保健机构之间的信息转移或妇女在家中使用 HBR 的情况，来自 LMIC 的文献有限。目前来自 LMIC 的 HBR 记录不完整，导致信息可用性较差，这违背了它们作为未来提供者信息来源的意义。
