Using Patient Portals to Improve Patient Outcomes: Systematic Review.
Using Patient Portals to Improve Patient Outcomes: Systematic Review.
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DOI：
10.2196/15038
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发表时间：
2019-12-19
影响因子：
2.7
通讯作者：
Bauer, Tom
中科院分区：
文献类型：
--
作者：
Han, Hae-Ra;Gleason, Kelly T;Bauer, Tom
背景：随着电子健康记录(EHR)系统的出现，人们越来越关注EHR系统在帮助患者通过安全的患者门户在他们的护理中发挥积极作用的使用。目的：本研究旨在综合有关患者门户干预的特征、心理行为和临床结局的证据。方法：2018年11月，我们检索了PubMed、EMBASE、护理和相关卫生文献的累积索引等3个电子数据库，共24篇文章符合资格标准。研究设计的类型各不相同，样本主要涉及非西班牙裔白人和受过高等教育的患者，人数从50人到22,703人不等。大多数门户干预使用针对患者情况量身定做的警报或教育资源。患者门户干预导致广泛的心理行为结果的改善，如健康知识、自我效能、决策、用药依从性和预防性服务使用。患者门户干预对包括血压、血糖、胆固醇和体重减轻在内的临床结果的影响是混合的。结论：患者门户干预总体上有效地改善了一些心理结果、用药依从性和预防性服务使用。没有足够的证据支持使用患者门户来改善临床结果。了解患者门户作为一种有效的干预策略的作用是鼓励患者积极参与医疗保健的关键一步。
BACKGROUND: With the advent of electronic health record (EHR) systems, there is increasing attention on the EHR system with regard to its use in facilitating patients to play active roles in their care via secure patient portals. However, there is no systematic review to comprehensively address patient portal interventions and patient outcomes.OBJECTIVE: This study aimed to synthesize evidence with regard to the characteristics and psychobehavioral and clinical outcomes of patient portal interventions.METHODS: In November 2018, we conducted searches in 3 electronic databases, including PubMed, EMBASE, and Cumulative Index to Nursing and Allied Health Literature, and a total of 24 articles met the eligibility criteria.RESULTS: All but 3 studies were conducted in the United States. The types of study designs varied, and samples predominantly involved non-Hispanic white and highly educated patients with sizes ranging from 50 to 22,703. Most of the portal interventions used tailored alerts or educational resources tailored to the patient's condition. Patient portal interventions lead to improvements in a wide range of psychobehavioral outcomes, such as health knowledge, self-efficacy, decision making, medication adherence, and preventive service use. Effects of patient portal interventions on clinical outcomes including blood pressure, glucose, cholesterol, and weight loss were mixed.CONCLUSIONS: Patient portal interventions were overall effective in improving a few psychological outcomes, medication adherence, and preventive service use. There was insufficient evidence to support the use of patient portals to improve clinical outcomes. Understanding the role of patient portals as an effective intervention strategy is an essential step to encourage patients to be actively engaged in their health care.