Table 1.
Summary of included primary PHR studies that measured benefit from use of PHR by patients
| Author | Conditions | Benefit | Level | # of patients | Study design and duration | Location | PHR type and features | Evaluation methods | Reported Benefits |
|---|---|---|---|---|---|---|---|---|---|
| Wiljer, 2010 [33] | Cancer | No | IV | 320 consented, 114 completed study | 6 weeks | Canada | Tethered PHR with access to personal health data (labs and diagnostic imaging), access to support groups and a virtual librarian. | State-Trait Anxiety Inventory; Stanford Self-Efficacy for Managing Chronic Disease | No change |
| Wade-Vuturo, 2013 [34] | Diabetes | Yes | IV | 54 patients | Crossectional: PHR use >1 year in 43 patients | USA | Tethered Portal with secure messaging, access to medical records | Patient Self-Report; Chart review to assess glycemic control (A1c). | Improved Patient Satisfaction with Care |
| Improved Disease Control | |||||||||
| More effective face-to-face visits | |||||||||
| Better Pt-Provider Communication | |||||||||
| Urowitz, 2012 [21] | Diabetes | Yes | IV | 17 patients | Crossectional, at least 6 months of access to PHR | Canada | Standalone PHR with ability to record personal health information and see trends, can also look up health information references. | Patient Self-Report | Improved Access to own information |
| Improved access to pt information by provider | |||||||||
| Improved ability to self manage | |||||||||
| More Activated Patient | |||||||||
| Tenforde, 2011 [35] | Diabetes | Yes | IV | 10,746 adult patients | Retrospective audit over 12 months | USA | Tethered PHR with secure messaging and access to health record data, reminders for follow up and health information | Chart review for diabetes indicators (A1c, LDL-C, BP, BMI). | Improved Disease Control |
| Wald, 2010 [36] | Diabetes | Yes | II | 2027 patients | prompt 3 weeks prior to encounter. | USA | Tethered PHR with secure messaging, access to health record data, Journal, and health information. | Patient and Provider Self Report | Improved Patient Satisfaction with Care |
| Improved access to pt information by provider | |||||||||
| More effective face-to-face visits | |||||||||
| More Activated Patient | |||||||||
| Hess, 2014 [37] | Diabetes (able to extract from paper) | Yes | IV | 504 patients | Pre post, one year | USA | Tethered PHR with reminders for preventive care | Patient documentation of care received | Improved Disease Control |
| Fonda, 2009 [38] | Diabetes | Yes | II | 104 patients | RCT, 52 weeks | USA | Tethered PHR with secure messaging, access to personal health data, educational materials. | Problem Areas in Diabetes (PAID) validated survey | Decreased Patient Distress |
| Lau, 2014 [39] | Diabetes | Yes | III-3 | 50 users and 107 non-users | 6-24 months | Canada | Standalone PHR with health information, journaling, entering health data, secure messaging with providers | Chart review to monitor A1c control | Improved Disease Control |
| Sarkar, 2014 [40] | Diabetes | Yes | III-3 | 8705 users with 9055 matched reference group | Observational cohort study, 1 year | USA | Tethered PHR with access to record, secure messaging, renewal requests, and online scheduling. | Measured renewal rates for statins over 1 year based on chart data | Improved Disease Control |
| Wald, 2009 [41] | Diabetes | Yes | IV | 37 patients | 2 week follow up, patients were already using the general PHR as part of inclusion. | USA | Tethered PHR with secure messaging, access to personal health data, decision support, ability to annotate their health record, care plan. | Self Report | Improved access to pt information by provider |
| More effective face-to-face visits | |||||||||
| Better Pt-Provider Communication | |||||||||
| Grant, 2008 [20] | Diabetes | No | II | 244 patients | RCT, use of PHR 52 weeks | USA | Tethered PHR with access to personal health data, decision support, care plans | DM indicators: BP control, A1c, LDL-C’ # of primary care visits. | No change |
| van Empel, 2011 [42] | Fertility | Yes | IV | 369 couples | Cross sectional survey | Netherlands | Tethered PHR with secure messaging, access to personal health data, social support/forums. | Patient Self-Report, Partner Self-Report | Improved Continuity |
| Improved access to health knowledge | |||||||||
| Better Pt-Provider Communication | |||||||||
| Boland 2014 [43] | Glaucoma | Yes | II | 38 intervention; 32 control | RCT; 3 months | USA | PHR that could record patient information and medications; daily reminders by text/phone to intervention group to take medication | Adherence monitoring with medication smart cap, patient surveys. | Improved medication management |
| Crouch, 2014 [44] | HIV | Yes | III-3 | 40 (20 users, 20 non-users) | Cross sectional | USA | Tethered PHR with access to labs, notes, secure communication and medication renewal. | Patient Activation Measure | More Activated Patient |
| Improved Disease Control | |||||||||
| Gordon, 2012 [45] | HIV | No | IV | 112 active users | Survey, access up to 114 weeks | USA | Tethered PHR viewer with access to personal health data. | Patient-Self Report | Improved Access to own information |
| Improved access to health knowledge | |||||||||
| More Activated Patient | |||||||||
| Kahn, 2010 [46] | HIV | Yes | IV | 221 users registered | cross sectional survey, access to PHR up to 21 months | USA | Tethered PHR with access to personal health data, ability to record own health data, access health information | Patient Self-Report | Better Pt-Provider Communication |
| Improved ability to self manage | |||||||||
| More Activated Patient | |||||||||
| McInnes, 2013 [47] | HIV | Yes | IV | 1871 patients | Cross sectional survey and chart review | USA | Tethered PHR with access to personal health data, request medication renewal, reminders for preventive care, scheduling appointments, secure messaging | Chart review, survey data from Veterans Aging Cohort Study | Improved ability to self manage |
| Shade, 2014 [48] | HIV | Yes | IV | Unclear at site using PHR | 12 month (6 pre and 6 post) study | USA | Standalone PHR with continuity of care patient summaries including HIV results; secure provider communication. | Chart review | Improved ability to self manage |
| Improved Disease Control | |||||||||
| Wagner, 2012 [49] | Hypertension | No | II | 453 users | RCT, PHR use up to 39 weeks (4 visits) | USA | Tethered PHR with secure messaging, access to personal health data, track personal health data, access to health information, care plan goal setting. | Patient Self-Report, Chart review for blood pressure | No change |
| Chiche, 2012 [50] | Idiopathic thrombocytopenic purpura (ITP) | No | III-2 | 43 patients | 26 weeks | France | Standalone PHR with ability to record personal health data | ITP patient assessment questionnaire | No change |
| Miller, 2011 [51] | Multiple Sclerosis | No | II | 204 patients recruited | RCT, 52 weeks | USA | Standalone PHR with ability to record personal health data and receive decision support (through MS Quality of Life Inventory) | Sickness Impact Profile, MS Functional Composite, Control Subscale of the MS Self-Efficacy Scale | No change |
| Seniors’ General Satisfaction and Physician Quality of Care | |||||||||
| Euro-Quality of Life 5 | |||||||||
| Solomon, 2012 [18] | Asthma, Hypertension, Diabetes | Yes | II | 201 patients | 12 week | USA | Tethered PHR with secure messaging and targeted health education weekly training modules. | Patient Activation Measure 13 (PAM-13) | Improved ability to self manage |
| Chart Review | More Activated Patient | ||||||||
| Sobko, 2011 [19] | Diabetes, hypertension, lipids | Yes | IV | 9504 | Cohort study - chart review 6 month pre and 14 months post PHR deployment | USA | Tethered PHR with access to health record, secure communication, decision support, medication renewal | Chart review: medication possession rates; A1c, blood pressure, lipids | Improved ability to self manage |
| Improved Disease Control |