Antiretroviral Therapy Adherence and Use of an Electronic Shared Medical Record Among People Living with HIV

Abstract

Electronic shared medical records (SMR) are emerging healthcare technologies that allow patients to engage in their healthcare by communicating with providers, refilling prescriptions, scheduling appointments, and viewing portions of medical records. We conducted a pre-post cohort study of HIV-positive adults who used and did not use SMR in two integrated healthcare systems. We compared the difference in antiretroviral refill adherence between SMR users and age- and sex-frequency matched non-users from the 12-month period prior to SMR use to the 12-month period starting six months after initiation of SMR use. High adherence was maintained among SMR users (change=−0.11%) but declined among non-users (change=−2.05%; p=0.003). Among SMR users, there was a steady improvement in adherence as monthly frequency of SMR use increased (p=0.009). SMR use, particularly more frequent use, is associated with maintaining high adherence and non-use is associated with declines in adherence over time among patients with access to these online services.

First-Line Antiretroviral Regimen Failure and Determinants in an Urban HIV Clinic at Phramongkutklao Hospital, Bangkok, Thailand: 20 Years Experience

“…Consequently, care plans should be developed to include reliable adherence measurements, for instance, a standardized questionnaire 21 , 22 and electronically shared medical records. 23 …”

Capturing the Impact of Patient Portals Based on the Quadruple Aim and Benefits Evaluation Frameworks: Scoping Review

“…Several studies have explored the correlation between patient portal use and medication adherence because of web-based reminders for refills and requests for prescription renewals [ 44 , 81 , 85 , 86 , 89 , 94 , 106 , 109 , 112 ]. A study found that once new users were given mobile access to the portal, there was a statistically significant improvement in adherence to oral diabetes drugs and lower glycemic levels [ 81 ].…”

“…The refill function, in combination with secure messaging, had a greater impact on HbA 1c levels. Another study observed stable refill adherence over time among portal users compared with small declines among nonusers [ 85 ]. Satisfaction with the refill portal function was high, as 69% would recommend e-refill requests to other patients, family, or friends, and 63% would request all or most of their prescription refills electronically [ 112 ].…”

“…A substantial gap in the literature was the lack of prospective longitudinal studies with large samples. There were a few prospective studies [ 55 , 65 , 85 ] that followed patients between 7 and 12 months; however, the sample sizes were small (between 20 and 94 participants). Nearly all studies that evaluated the patient perspective acknowledged that the study samples were made up of early adopters and individuals from the higher socioeconomic spectrum.…”

Secure Messaging Through PositiveLinks: Examination of Electronic Communication in a Clinic-Affiliated Smartphone App for Patients Living with HIV

“…8,9 The use of patient portals is associated with higher medication adherence 9,10 including for patients with HIV. 11 HIV patients who use secure messaging have a trend toward higher likelihood of achieving viral suppression. 12 The portal features most valued by patients are patientprovider messaging and access to test results.…”