title: Personal health record use and its association with antiretroviral adherence: survey and medical record data from 1871 US veterans infected with HIV.
abstract: Patient electronic personal health record (PHR) use has been associated with improved patient outcomes in diabetes and depression care. Little is known about the effect of PHR use on HIV care processes and outcomes. We evaluated whether there was an association between patient PHR use and antiretroviral adherence. Data came from the Veterans Aging Cohort Study and included cross-sectional survey and medical record data from 1871 HIV+ veterans. Our adherence measure was an antiretroviral medication possession ratio, dichotomized at 0.90, and based on pharmacy refill data. In our sample 44 % did not use the internet, 14 % used internet but not for health, 27 % used internet for health but not the PHR, and 14 % used the PHR. In multivariable analysis PHR use was associated with ≥90 % adherence after controlling for socio-demographic variables. Findings provide support for longitudinal studies and studies that identify which PHR functions (e.g. online medication refills, viewing lab results, secure messaging with providers) are most closely associated with medication adherence.
authors: VA QUERI Program and VA New England Healthcare System, Bedford VA Medical Center, 200 Springs Road, Building 70, Bedford, MA, 01730, USA, mcinnes@bu.edu.
authors: D
authors: D
authors: Keith McInnes
authors: Stephanie L
authors: SL
authors: Shimada
authors: Sowmya R
authors: SR
authors: Rao
authors: Ann
authors: A
authors: Quill
authors: Mona
authors: M
authors: Duggal
authors: Allen L
authors: AL
authors: Gifford
authors: Cynthia A
authors: CA
authors: Brandt
authors: Thomas K
authors: TK
authors: Houston
authors: Michael E
authors: ME
authors: Ohl
authors: Kirsha S
authors: KS
authors: Gordon
authors: Kristin M
authors: KM
authors: Mattocks
authors: Lewis E
authors: LE
authors: Kazis
authors: Amy C
authors: AC
authors: Justice
mesh_terms: D000328:Adult; D000368:Aged; D019380:Anti-HIV Agents / Q000008:administration & dosage*; D003430:Cross-Sectional Studies; D057286:Electronic Health Records; D005260:Female; D015658:HIV Infections / Q000188:drug therapy* / Q000453:epidemiology; D055991:Health Records, Personal; D006801:Humans; D008297:Male; D008875:Middle Aged; D012646:Self Administration; D012959:Socioeconomic Factors; D019966:Substance-Related Disorders / Q000453:epidemiology; D011795:Surveys and Questionnaires; D014481:United States / Q000453:epidemiology; D014728:Veterans / Q000706:statistics & numerical data*; D019562:Viral Load; D016903:Drug Monitoring
chemical_list: D019380:Anti-HIV Agents