J. Med. Internet Res. - Impact of patient access to Internet health records on glaucoma medication: randomized controlled trial.


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CKGROUND: Glaucoma is one of the leading causes of blindness. Reduction of intraocular pressure is the only proven way to prevent progression of glaucomatous optic neuropathy. The majority of glaucoma patients need to use antiglaucoma ophthalmic solutions over the course of their life. Thus, good adherence and persistency of glaucoma treatment are important factors for better glaucoma care.OBJECTIVE: The purpose of this study was to investigate the impact of an Internet-based glaucoma care support system on glaucoma medication use.METHODS: Patients were randomly divided into two groups. The non-Internet access (NIA) group consisted of patients who had access to the Internet-based glaucoma care support system during the 4-year period only when they were examined by ophthalmologists. The Internet access (IA) group consisted of patients who had the same Internet-based glaucoma care support system access as the NIA group for the first 2 years following enrollment but who were also given free access to the glaucoma care support system for the remaining 2 years. Changes in glaucoma medication use were investigated.RESULTS: In total, 81 patients in the IA group and 90 patients in the NIA group satisfied the study protocol. The number of antiglaucoma ophthalmic solutions used during the study period significantly increased in the NIA group (P<.03) but not in the IA group. The percentages of patients with unchanged, increased, and decreased antiglaucoma ophthalmic solution use during the study period were 61.1% (55/90), 17.8% (16/90), and 3.3% (3/90), respectively, in the NIA group, and 56.8% (46/81), 8.6% (7/81), and 13.6% (11/81), respectively, in the IA group (P<.001). Internet access significantly shifted from an increasing intraocular pressure trend to a decreasing trend in the IA group (P=.002) among the patients who did not have any medication changes.CONCLUSIONS: Allowing patients to browse their medical data may reduce the use and improve the effectiveness of glaucoma medication.TRIAL REGISTRATION: UMIN-CTR Clinical Trial Number: UMIN000006982; https://upload.umin.ac.jp/cgi-open-bin/ctr/ctr.cgi?function=brows&action=brows&type=summary&recptno=R000008238&language=E (Archived by WebCite at http://www.webcitation.org/6MRPQeEAv).

Resumo Limpo

ckground glaucoma one lead caus blind reduct intraocular pressur proven way prevent progress glaucomat optic neuropathi major glaucoma patient need use antiglaucoma ophthalm solut cours life thus good adher persist glaucoma treatment import factor better glaucoma careobject purpos studi investig impact internetbas glaucoma care support system glaucoma medic usemethod patient random divid two group noninternet access nia group consist patient access internetbas glaucoma care support system year period examin ophthalmologist internet access ia group consist patient internetbas glaucoma care support system access nia group first year follow enrol also given free access glaucoma care support system remain year chang glaucoma medic use investigatedresult total patient ia group patient nia group satisfi studi protocol number antiglaucoma ophthalm solut use studi period signific increas nia group p ia group percentag patient unchang increas decreas antiglaucoma ophthalm solut use studi period respect nia group respect ia group p internet access signific shift increas intraocular pressur trend decreas trend ia group p among patient medic changesconclus allow patient brows medic data may reduc use improv effect glaucoma medicationtri registr uminctr clinic trial number umin httpsuploaduminacjpcgiopenbinctrctrcgifunctionbrowsactionbrowstypesummaryrecptnorlanguage archiv webcit httpwwwwebcitationorgmrpqeeav

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