What are the essential design features of personal health records to improve medication adherence: A literature review
1. What are the Essential Design Features of Personal
Health Records to improve medication adherence:
A literature review
Elisavet Andrikopoulou
PhD Student 1st
year
University of Portsmouth
Centre for Healthcare Modelling & Informatics
Supervisor: Dr Philip Scott
elisavet.andrikopoulou@port.ac.uk
http://www.prayance.co.uk
@Prayance
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2. Problem and Objectives
Background
• How can personal health records (PHRs) assist adults with long term conditions
improve their medication adherence? What do we know so far?
• How can we:
1. …optimise the PHR technology to fit patient personalities and improve
medication adherence?
2. …use wearable technologies with PHRs to assist medication adherence?
3. …make PHRs more usable for adults with long term conditions?
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Medication
adherence: “the
extent to which a
person’s behaviour
towards their
treatment, agrees with
suggestions from a
clinician”
Polypharmacy: “the
prescribing of multiple
(more than 10) items
of medication to one
individual”
“50% of PHR providers
do not have any
medication adherence
functionality
embedded in their
systems”
3. Methodology: Inclusion/Exclusion criteria and PICO model
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Inclusion criteria Exclusion criteria
Participants
• Humans
• 18 years or older suffering from diabetes type 1
and self-administering insulin
• adults suffering from at least one chronic
condition and polypharmacy
• Patients that can self-administer their
medication
• Patients treated outside the hospital only
• Animals
• Pregnant, mentally ill, cancer or terminally ill patients
• adults with multiple chronic conditions but not
polypharmacy or with polypharmacy, but not chronic
conditions
• Patients that require assistance with their medication
• Inpatients only or patients living in care homes
Intervention
Interventions of any type, intensity and frequency,
that aim to investigate the effect of electronic PHRs
in medication adherence, concordance, compliance
or persistence.
Interventions that focus solely on one condition not
investigating comorbidity.
Comparators N/A N/A
Outcome
Any outcome related to the effect of electronic
PHRs in medication adherence, concordance,
compliance or persistence.
N/A
Study
design/type
Published studies from 2012 to 2017, without any
geographical restriction.
Abstract-only reports without any references, commercial
studies, party political statements, review papers,
magazine or newspaper articles, withdrawn abstracts or
articles, protocols of reviews.
Table 1: Summary of the PICOS elements included and excluded in the systematic literature review
4. Quality assessment, data analysis & search strategy
Future Work
a) b)
• Cochrane GRADE system and the CASP
checklists will be combined for quality
assessment and risk of bias analysis.
• The databases searches include keywords
such as PHR, polypharmacy, adults,
chronic condition and medication
adherence.
• Narrative synthesis of known ways that
the PHR are used to assist chronically ill
patients with medication adherence.
This literature review will provide a reference background in evaluation of the
electronic PHR, to support medicines optimisation and improving shared
understanding for patients and practitioners.
Figure 1: PRISMA Flow Diagram (still in progress)
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