Systematic review on the use of patient-held health records in low-income and middle-income countries.
Systematic review on the use of patient-held health records in low-income and middle-income countries.
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关于低收入和中等收入国家使用患者控制的健康记录的系统审查。
DOI：
10.1136/bmjopen-2020-046965
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发表时间：
2021-09-02
期刊：
影响因子：
2.9
通讯作者：
Manaseki-Holland S
中科院分区：
文献类型：
--
作者：
Joseph L;Lavis A;Greenfield S;Boban D;Humphries C;Jose P;Jeemon P;Manaseki-Holland S
审查关于患者持有的健康记录（PHR）（孕产妇和儿童健康记录除外）的益处的现有证据，以改善医疗保健提供者（HCP）之间和/或低收入和中等收入国家（LMIC）HCP与患者之间的交接沟通的医疗信息可用性。在PubMed、EMBASE、CINAHL数据库中对手稿进行文献检索，不限制日期/语言。此外，通过使用先前的系统性综述进行引文检查，并通过联系专家进行灰色文献检索，检索WHO网站和Google Scholar，查找文章。在4个LMIC中开展的6项观察性研究符合入选标准。然而，没有研究报告使用PHRs后的健康结果。综述中的研究报告了患者将记录携带给HCP（n=3）的经验、HCP可用信息的质量（n=1）以及这些记录对患者（n=6）和HCP（n=4）的效用。大多数患者携带PHR进行医疗保健访问。一项研究评估了临床移交信息的完整性，发现只有41%（161/395）的PHR在诊断、治疗和随访的关键信息方面是完整的。未报告HCP使用PHR的方案或指南。HCP认为PHR的使用改善了其他HCP的医疗信息可用性。从病人的角度来看，PHR的功能是记录有关其自身状况的信息来源。关于现有的《医生促进健康条例》的数据有限，因此这些条例对改善中低收入国家的健康结果的益处不确定。这种知识差距要求研究了解患者和HCP以及卫生系统干预措施中PHR使用的动态和结果。CRD 42019139365。
To review the available evidence on the benefit of patient-held health records (PHRs), other than maternal and child health records, for improving the availability of medical information for handover communication between healthcare providers (HCPs) and/or between HCPs and patients in low-income and middle-income countries (LMICs). The literature searches were conducted in PubMed, EMBASE, CINAHL databases for manuscripts without any restrictions on dates/language. Additionally, articles were located through citation checking using previous systematic reviews and a grey literature search by contacting experts, searching of the WHO website and Google Scholar. Six observational studies in four LMICs met the inclusion criteria. However, no studies reported on health outcomes after using PHRs. Studies in the review reported patients’ experience of carrying the records to HCPs (n=3), quality of information available to HCPs (n=1) and the utility of these records to patients (n=6) and HCPs (n=4). Most patients carry PHRs to healthcare visits. One study assessed the completeness of clinical handover information and found that only 41% (161/395) of PHRs were complete with respect to key information on diagnosis, treatment and follow-up. No protocols or guidelines for HCPs were reported for use of PHRs. The HCPs perceived the use of PHRs improved medical information availability from other HCPs. From the patient perspective, PHRs functioned as documented source of information about their own condition. Limited data on existing PHRs make their benefits for improving health outcomes in LMICs uncertain. This knowledge gap calls for research on understanding the dynamics and outcomes of PHR use by patients and HCPs and in health systems interventions. CRD42019139365.
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