title: Personal health records: a randomized trial of effects on elder medication safety.
abstract: OBJECTIVE
  To examine the impact of a personal health record (PHR) on medication-use safety among older adults.
  
  
  BACKGROUND
  Online PHRs have potential as tools to manage health information. We know little about how to make PHRs accessible for older adults and what effects this will have.
  
  
  METHODS
  A PHR was designed and pretested with older adults and tested in a 6-month randomized controlled trial. After completing mailed baseline questionnaires, eligible computer users aged 65 and over were randomized 3:1 to be given access to a PHR (n=802) or serve as a standard care control group (n=273). Follow-up questionnaires measured change from baseline medication use, medication reconciliation behaviors, and medication management problems.
  
  
  RESULTS
  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.
  
  
  CONCLUSIONS
  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.
authors: Department of Epidemiology, College of Public Health, The University of Iowa, Iowa City, Iowa, USA Institute for Clinical and Translational Science, The University of Iowa, Iowa City, Iowa, USA.
authors: Elizabeth A
authors: EA
authors: Chrischilles
authors: Department of Computer Science, College of Liberal Arts, The University of Iowa, Iowa City, Iowa, USA.
authors: Juan Pablo
authors: JP
authors: Hourcade
authors: College of Pharmacy, The University of Iowa, Iowa City, Iowa, USA.
authors: William
authors: W
authors: Doucette
authors: School of Library and Information Science, The University of Iowa, Iowa City, Iowa, USA.
authors: David
authors: D
authors: Eichmann
authors: Department of Epidemiology, College of Public Health, The University of Iowa, Iowa City, Iowa, USA.
authors: Brian
authors: B
authors: Gryzlak
authors: Institute for Clinical and Translational Science, The University of Iowa, Iowa City, Iowa, USA.
authors: Ryan
authors: R
authors: Lorentzen
authors: Department of Epidemiology, College of Public Health, The University of Iowa, Iowa City, Iowa, USA.
authors: Kara
authors: K
authors: Wright
authors: Department of Epidemiology, College of Public Health, The University of Iowa, Iowa City, Iowa, USA.
authors: Elena
authors: E
authors: Letuchy
authors: Department of Epidemiology, College of Public Health, The University of Iowa, Iowa City, Iowa, USA.
authors: Michael
authors: M
authors: Mueller
authors: College of Pharmacy, The University of Michigan, Ann Arbor, Michigan, USA.
authors: Karen
authors: K
authors: Farris
authors: Department of Epidemiology, College of Public Health, The University of Iowa, Iowa City, Iowa, USA Department of Family Medicine, Carver College of Medicine, The University of Iowa, Iowa City, Iowa, USA.
authors: Barcey
authors: B
authors: Levy
mesh_terms: D000368:Aged; D000894:Anti-Inflammatory Agents, Non-Steroidal / Q000627:therapeutic use; D057286:Electronic Health Records; D005260:Female; D055991:Health Records, Personal; D006801:Humans; D008297:Male; D061214:Patient Safety; D012646:Self Administration / Q000706:statistics & numerical data; D012651:Self Medication / Q000706:statistics & numerical data*; D011795:Surveys and Questionnaires; D016903:Drug Monitoring
chemical_list: D000894:Anti-Inflammatory Agents, Non-Steroidal
keywords: Medication Management; Patient Safety; Personal Health Record