An exploratory study to examine the impact of electronic personal health records on medication adherence and patient engagement among nonvalvular atrial fibrillation patients

Abstract

Objective: The aim of this study was to examine the impact of electronic personal health records (ePHRs) and ePHR-facilitated medication education on medication adherence, medication knowledge, and patient engagement. Methods: A two-arm randomized, prospective study was conducted at a regional medical center in northeastern Indiana from January 2014 to June 2014. The medical center allows patients to view online, download, and transmit health information via the ePHR system. Atrial fibrillation patients who took dabigatran to prevent stroke were invited to participate in this study. The intervention group received ePHR training as well as dabigatran education via the ePHR system. The control group received the standard care and ePHR access without any training or health education. A longitudinal survey, comprising 54 questions pertaining to technology acceptance, medication knowledge, medication adherence, and patient activation measure (PAM), was sent to both groups at the baseline and the end of study. Medication dispensing data collected from the pharmacy where patients had their prescriptions filled were used for calculating the medication possession ratio (MPR). Descriptive statistics and paired t tests were performed using SPSS version 22.0. Results: Ninety patients were recruited into this study and randomly assigned to intervention group (n = 46) or control group (n = 44). All patients completed the baseline survey and 95.6% of patients finished the follow-up survey. Mean score on knowledge of dabigatran increased significantly in the intervention group (3.77 to 4.23; P = 0.007) but not the control group (3.70 to 3.95; P = 0.72). The MPR was higher in the intervention group (93.7% vs. 87.1%; P = 0.09). Both groups had similar improvement in PAM scores (63.0 to 65.8; P = 0.078 vs. 63.1 to 63.6; P = 0.814). Conclusion: Patients who had ePHR access and received training and education about this technology achieved greater medication knowledge. Use of the ePHRs also may improve patients' medication adherence and engagement in their health care.