Personal health records: a randomized trial of effects on elder medication safety

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First Review

This is a review for "Personal health records: a randomized trial of effects on elder medication safety". [1]


The purpose of the study was to examine the impact of a personal health record (PHR) on medication-use among older adults.


A PHR was designed and pretested in a 6-month randomized controlled trial with older adults. After completing mailed baseline questionnaires, eligible computer users aged 65 and over were randomized 3:1 to be given access to a PHR. Follow-up questionnaires measured change from baseline medication use, medication reconciliation behaviors, and medication management problems.


Older adults were interested in keeping track of their health and medication information. A majority (55.2%) logged into the PHR and used it, but only 16.1% used it frequently. At follow-up, those randomized to the PHR group were significantly less likely to use multiple non-steroidal anti-inflammatory drugs—the most common warning generated by the system (viewed by 23% of participants). Compared with low/non-users, high users reported significantly more changes in medication use and improved medication reconciliation behaviors, and recognized significantly more side effects, but there was no difference in use of inappropriate medications or adherence measures.


PHRs can engage older adults for better medication self-management; however, features that motivate continued use will be needed. Longer-term studies of continued users will be required to evaluate the impact of these changes in behavior on patient health outcomes.


In this day and age when almost everything is easily accessible from our smartphones, it's hard to understand why more participants of the study did not engage in continued use of the PHR. I agree that longer studies are needed to understand how to engage and motivate for continued use in order to evaluate the impact of any changes in behavior and patient health outcomes.


  1. Journal of the American Medical Informatics Association Jul 2014, 21 (4) 679-686; DOI: 10.1136/amiajnl-2013-002284