J Am Med Inform Assoc - Effects of an online personal health record on medication accuracy and safety: a cluster-randomized trial.

Tópicos

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Resumo

JECTIVE: To determine the effects of a personal health record (PHR)-linked medications module on medication accuracy and safety.DESIGN: From September 2005 to March 2007, we conducted an on-treatment sub-study within a cluster-randomized trial involving 11 primary care practices that used the same PHR. Intervention practices received access to a medications module prompting patients to review their documented medications and identify discrepancies, generating 'eJournals' that enabled rapid updating of medication lists during subsequent clinical visits.MEASUREMENTS: A sample of 267 patients who submitted medications eJournals was contacted by phone 3 weeks after an eligible visit and compared with a matched sample of 274 patients in control practices that received a different PHR-linked intervention. Two blinded physician adjudicators determined unexplained discrepancies between documented and patient-reported medication regimens. The primary outcome was proportion of medications per patient with unexplained discrepancies.RESULTS: Among 121,046 patients in eligible practices, 3979 participated in the main trial and 541 participated in the sub-study. The proportion of medications per patient with unexplained discrepancies was 42% in the intervention arm and 51% in the control arm (adjusted OR 0.71, 95% CI 0.54 to 0.94, p=0.01). The number of unexplained discrepancies per patient with potential for severe harm was 0.03 in the intervention arm and 0.08 in the control arm (adjusted RR 0.31, 95% CI 0.10 to 0.92, p=0.04).CONCLUSIONS: When used, concordance between documented and patient-reported medication regimens and reduction in potentially harmful medication discrepancies can be improved with a PHR medication review tool linked to the provider's medical record.TRIAL REGISTRATION NUMBER: This study was registered at ClinicalTrials.gov (NCT00251875).

Resumo Limpo

jectiv determin effect person health record phrlink medic modul medic accuraci safetydesign septemb march conduct ontreat substudi within clusterrandom trial involv primari care practic use phr intervent practic receiv access medic modul prompt patient review document medic identifi discrep generat ejourn enabl rapid updat medic list subsequ clinic visitsmeasur sampl patient submit medic ejourn contact phone week elig visit compar match sampl patient control practic receiv differ phrlink intervent two blind physician adjud determin unexplain discrep document patientreport medic regimen primari outcom proport medic per patient unexplain discrepanciesresult among patient elig practic particip main trial particip substudi proport medic per patient unexplain discrep intervent arm control arm adjust ci p number unexplain discrep per patient potenti sever harm intervent arm control arm adjust rr ci pconclus use concord document patientreport medic regimen reduct potenti harm medic discrep can improv phr medic review tool link provid medic recordtri registr number studi regist clinicaltrialsgov nct

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