J Am Med Inform Assoc - Impact of a web-based personally controlled health management system on influenza vaccination and health services utilization rates: a randomized controlled trial.

Tópicos

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Resumo

JECTIVE: To assess the impact of a web-based personally controlled health management system (PCHMS) on the uptake of seasonal influenza vaccine and primary care service utilization among university students and staff.MATERIALS AND METHODS: A PCHMS called Healthy.me was developed and evaluated in a 2010 CONSORT-compliant two-group (6-month waitlist vs PCHMS) parallel randomized controlled trial (RCT) (allocation ratio 1:1). The PCHMS integrated an untethered personal health record with consumer care pathways, social forums, and messaging links with a health service provider.RESULTS: 742 university students and staff met inclusion criteria and were randomized to a 6-month waitlist (n=372) or the PCHMS (n=370). Amongst the 470 participants eligible for primary analysis, PCHMS users were 6.7% (95% CI: 1.46 to 12.30) more likely than the waitlist to receive an influenza vaccine (waitlist: 4.9% (12/246, 95% CI 2.8 to 8.3) vs PCHMS: 11.6% (26/224, 95% CI 8.0 to 16.5); (2)=7.1, p=0.008). PCHMS participants were also 11.6% (95% CI 3.6 to 19.5) more likely to visit the health service provider (waitlist: 17.9% (44/246, 95% CI 13.6 to 23.2) vs PCHMS: 29.5% (66/224, 95% CI: 23.9 to 35.7); (2)=8.8, p=0.003). A dose-response effect was detected, where greater use of the PCHMS was associated with higher rates of vaccination (p=0.001) and health service provider visits (p=0.003).DISCUSSION: PCHMS can significantly increase consumer participation in preventive health activities, such as influenza vaccination.CONCLUSIONS: Integrating a PCHMS into routine health service delivery systems appears to be an effective mechanism for enhancing consumer engagement in preventive health measures.TRIAL REGISTRATION: Australian New Zealand Clinical Trials Registry ACTRN12610000386033. http://www.anzctr.org.au/trial_view.aspx?id=335463.

Resumo Limpo

jectiv assess impact webbas person control health manag system pchms uptak season influenza vaccin primari care servic util among univers student staffmateri method pchms call healthym develop evalu consortcompli twogroup month waitlist vs pchms parallel random control trial rct alloc ratio pchms integr unteth person health record consum care pathway social forum messag link health servic providerresult univers student staff met inclus criteria random month waitlist n pchms n amongst particip elig primari analysi pchms user ci like waitlist receiv influenza vaccin waitlist ci vs pchms ci p pchms particip also ci like visit health servic provid waitlist ci vs pchms ci p doserespons effect detect greater use pchms associ higher rate vaccin p health servic provid visit pdiscuss pchms can signific increas consum particip prevent health activ influenza vaccinationconclus integr pchms routin health servic deliveri system appear effect mechan enhanc consum engag prevent health measurestri registr australian new zealand clinic trial registri actrn httpwwwanzctrorgautrialviewaspxid

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