title: Antiretroviral Therapy Adherence and Use of an Electronic Shared Medical Record Among People Living with HIV.
abstract: Electronic shared medical records (SMR) are emerging healthcare technologies that allow patients to engage in their healthcare by communicating with providers, refilling prescriptions, scheduling appointments, and viewing portions of medical records. We conducted a pre-post cohort study of HIV-positive adults who used and did not use SMR in two integrated healthcare systems. We compared the difference in antiretroviral refill adherence between SMR users and age- and sex-frequency matched non-users from the 12-month period prior to SMR useto the 12-month period starting 6 months after initiation of SMR use. High adherence was maintained among SMR users (change = -0.11 %) but declined among non-users (change = -2.05 %; p = 0.003). Among SMR users, there was a steady improvement in adherence as monthly frequency of SMR use increased (p = 0.009). SMR use, particularly more frequent use, is associated with maintaining high adherence and non-use is associated with declines in adherence over time among patients with access to these online services.
authors.affiliation: Department of Medicine, University of California, San Francisco, San Francisco, CA, USA.
authors.forename: Parya
authors.initials: P
authors.lastname: Saberi
authors.forename: Sheryl L
authors.initials: SL
authors.lastname: Catz
authors.forename: Wendy A
authors.initials: WA
authors.lastname: Leyden
authors.forename: Christine
authors.initials: C
authors.lastname: Stewart
authors.forename: James D
authors.initials: JD
authors.lastname: Ralston
authors.forename: Michael A
authors.initials: MA
authors.lastname: Horberg
authors.forename: Louis
authors.initials: L
authors.lastname: Grothaus
authors.forename: Michael J
authors.initials: MJ
authors.lastname: Silverberg
mesh_terms: D000328:Adult; D023241:Antiretroviral Therapy, Highly Active; D015331:Cohort Studies; D003299:Cooperative Behavior; D019033:Delivery of Health Care, Integrated; D011307:Drug Prescriptions / Q000706:statistics & numerical data*; D057286:Electronic Health Records; D005260:Female; D015658:HIV Infections / Q000188:drug therapy*; D006801:Humans; D008297:Male; D008498:Medical Record Linkage / Q000379:methods*; D008875:Middle Aged; D010358:Patient Participation; D019562:Viral Load; D016903:Drug Monitoring