Table 8.

Who studied: what studied - where Care Provider: Patient held maternal and/or child records - developed countries

	Type of study	Research question*	Results (positive outcome of having record)	Results (neutral)	Results (negative outcome of having record)
[101] McElligott JT, et al. 2010.	Government-provided data analysis	Are PHR for childhood immunizations positively correlated with being up-to-date on vaccines?	In US, especially with more disadvantaged families, holding vaccination record associated with higher rates of immunization; odds for child being up-to-date determined as 62% greater for children with PHR.
[102] MacFarlane A, et al. 1990.	Retrospective study (#239)	What are the reactions of general practitioners and health visitors of PHCR?	In Oxfordshire, the majority of providers (over 90%) with experience with PHR have positive response to PHCR due to ability to access information, minimal experience of loss. Providers WITHOUT experience much more uncertain, only 59% view PHR positively.
[103] Toohill J, et al. 2006.	Audit /survey (#1256)	Are PHMR returned with mother at time of delivery, and does education improve return rate (Australia)?	The majority of mothers returned their records. Compliance numbers increased over time with education on importance of recordkeeping (82 to 88.5% increase in compliance).	There were some issues for healthcare providers for maintaining record completeness if record not available.
[69] Jeffs D, et al. 1994.	Random sample interview (#622)	Are PHR retained and used to appropriately to record immunizations, and are parents and providers satisfied with their use (New South Wales)?	The majority (93%) of parents retained their records, with the majority having at least one (91%), and a smaller majority (68%) having all immunizations recorded in the record by. The majority of providers are (80–90%) satisfied with the use of the record.	A smaller than hoped for number of providers (29–79%) had the purpose of the PHR explained to them, and a wide range in the professionals who used the records (30–96%).
[68] Charles R. 1994.	Survey and case control comparison of physical records (#155)	Is the parent held record an effective means of communication, does it derive any benefit if yes, and is the North Staffordshire PHR a good quality source of patient information for parents (#100) and professionals (#55)?	The vast majority of parents (87–99%), nurses (67–100%) and health visitors (70–100%) agreed with a smaller majority of doctors (53–78%) that the child’s individual record plus the information on child healthcare helped improve communication and care in at least 3 areas. Audits compared to clinic held records revealed significantly more information recorded on the parent held record.		Doctors expressed concerns about maintaining confidentiality, extra burden of work in maintaining the records, the size of the record and fears that patients wouldn’t bring the record to clinic visits (this final concern may be dispelled by the increased amount of information recorded in the PHR).
[76] Brown HC, et al. 2004.	Systematic review (3 studies)	What are the effects of having women carry their own case notes during pregnancy?		Inconclusive health outcomes. Providers report an increase in the number of surgical interventions with women carrying their PHR. This might be a positive finding in developing countries where the problem is lack of intervention in high-risk cases.	Providers report an increase in the number of surgical interventions with women carrying their PHR. This might be a positive finding in developing countries where the problem is lack of intervention in high-risk cases.
[104] Wilkinson SA, et al. 2007.	Descriptive - survey (#7) /review discussion (#25+)	What are the effects of having women carry a new enhanced record during pregnancy (Queensland)?			Care providers felt that the new record was too large for the patient to carry, and contained too much information to be useful to mother. Suggested a smaller patient-centered document for mother, and full record to be kept in clinic.

^*See notes regarding research question(s) and results