title: Impact of patient access to Internet health records on glaucoma medication: randomized controlled trial.
abstract: BACKGROUND
  Glaucoma is one of the leading causes of blindness. Reduction of intraocular pressure is the only proven way to prevent progression of glaucomatous optic neuropathy. The majority of glaucoma patients need to use antiglaucoma ophthalmic solutions over the course of their life. Thus, good adherence and persistency of glaucoma treatment are important factors for better glaucoma care.
  
  
  OBJECTIVE
  The purpose of this study was to investigate the impact of an Internet-based glaucoma care support system on glaucoma medication use.
  
  
  METHODS
  Patients were randomly divided into two groups. The non-Internet access (NIA) group consisted of patients who had access to the Internet-based glaucoma care support system during the 4-year period only when they were examined by ophthalmologists. The Internet access (IA) group consisted of patients who had the same Internet-based glaucoma care support system access as the NIA group for the first 2 years following enrollment but who were also given free access to the glaucoma care support system for the remaining 2 years. Changes in glaucoma medication use were investigated.
  
  
  RESULTS
  In total, 81 patients in the IA group and 90 patients in the NIA group satisfied the study protocol. The number of antiglaucoma ophthalmic solutions used during the study period significantly increased in the NIA group (P<.03) but not in the IA group. The percentages of patients with unchanged, increased, and decreased antiglaucoma ophthalmic solution use during the study period were 61.1% (55/90), 17.8% (16/90), and 3.3% (3/90), respectively, in the NIA group, and 56.8% (46/81), 8.6% (7/81), and 13.6% (11/81), respectively, in the IA group (P<.001). Internet access significantly shifted from an increasing intraocular pressure trend to a decreasing trend in the IA group (P=.002) among the patients who did not have any medication changes.
  
  
  CONCLUSIONS
  Allowing patients to browse their medical data may reduce the use and improve the effectiveness of glaucoma medication.
  
  
  BACKGROUND
  UMIN-CTR Clinical Trial Number: UMIN000006982; https://upload.umin.ac.jp/cgi-open-bin/ctr/ctr.cgi?function=brows&action=brows&type=summary&recptno=R000008238&language=E (Archived by WebCite at http://www.webcitation.org/6MRPQeEAv).
authors.affiliation: Faculty of Medicine, University of Yamanashi, Chuo, Japan. kenjik@yamanashi.ac.jp.
authors.forename: Kenji
authors.initials: K
authors.lastname: Kashiwagi
authors.forename: Shigeo
authors.initials: S
authors.lastname: Tsukahara
mesh_terms: D022126:Access to Information; D005901:Glaucoma / Q000188:drug therapy*; D006801:Humans; D020407:Internet; D009883:Ophthalmic Solutions; D011446:Prospective Studies; D016037:Single-Blind Method
chemical_list: D009883:Ophthalmic Solutions
keywords: Internet; glaucoma; intraocular pressure; medication; personal health record