title: Personal health records and hypertension control: a randomized trial.
abstract: OBJECTIVE
  To examine the impact of a personal health record (PHR) in patients with hypertension measured by changes in biological outcomes, patient empowerment, patient perception of quality of care, and use of medical services.
  
  
  METHODS
  A cluster-randomized effectiveness trial with PHR and no PHR groups was conducted in two ambulatory clinics. 453 of 1686 (26.4%) patients approached were included in the analyses. A PHR tethered to the patient's electronic medical record (EMR) was the primary intervention and included security measures, patient control of access, limited transmission of EMR data, blood pressure (BP) tracking, and appointment assistance. BP was the main outcome measure. Patient empowerment was assessed using the Patient Activation Measure and Patient Empowerment Scale. Quality of care was assessed using the Clinician and Group Assessment Score (CAHPS) and the Patient Assessment of Chronic Illness Care. Frequency of use of medical services was self-reported.
  
  
  RESULTS
  No impact of the PHR was observed on BP, patient activation, patient perceived quality, or medical utilization in the intention-to-treat analysis. Sub-analysis of intervention patients self-identified as active PHR users (25.7% of those with available information) showed a 5.25-point reduction in diastolic BP. Younger age, self-reported computer skills, and more positive provider communication ratings were associated with frequency of PHR use.
  
  
  CONCLUSIONS
  Few patients provided with a PHR actually used the PHR with any frequency. Thus simply providing a PHR may have limited impact on patient BP, empowerment, satisfaction with care, or use of health services without additional education or clinical intervention designed to increase PHR use.
  
  
  BACKGROUND
  http://ClinicalTrials.gov Identifier: NCT01317537.
authors.affiliation: School of Medicine, Department of Family Medicine, Georgia Health Sciences University, Augusta, Georgia, USA. pwagner@georgiahealth.edu
authors.forename: Peggy J
authors.initials: PJ
authors.lastname: Wagner
authors.forename: James
authors.initials: J
authors.lastname: Dias
authors.forename: Shalon
authors.initials: S
authors.lastname: Howard
authors.forename: Kristina W
authors.initials: KW
authors.lastname: Kintziger
authors.forename: Matthew F
authors.initials: MF
authors.lastname: Hudson
authors.forename: Yoon-Ho
authors.initials: YH
authors.lastname: Seol
authors.forename: Pat
authors.initials: P
authors.lastname: Sodomka
mesh_terms: D001294:Attitude to Health; D057286:Electronic Health Records / Q000706:statistics & numerical data; D005260:Female; D055991:Health Records, Personal; D006801:Humans; D006973:Hypertension / Q000628:therapy*; D057194:Intention to Treat Analysis; D008297:Male; D008875:Middle Aged; D017063:Outcome Assessment, Health Care; D018802:Patient-Centered Care; D011209:Power, Psychological; D011446:Prospective Studies; D011787:Quality of Health Care; D012648:Self Care; D014481:United States