Important Design Features of Personal Health Records to Improve Medication Adherence for Patients with Long-Term Conditions: Protocol for a Systematic Literature Review

Abstract

Journal of Medical Internet Research - International Scientific Journal for Medical Research, Information and Communication on the Internet #Preprint #PeerReviewMe: Warning: This is a unreviewed preprint. Readers are warned that the document has not been peer-reviewed by expert/patient reviewers or an academic editor, may contain misleading claims, and is likely to undergo changes before final publication, if accepted, or may have been rejected/withdrawn. Readers with interest and expertise are encouraged to sign up as peer-reviewer, if the paper is within an open peer-review period. Please cite this preprint only for review purposes or for grant applications and CVs (if you are the author). Background: NHS England spent £15.5 billion on medication in 2015. More than a third of patients affected by at least one long term condition do not adhere to their drug regime. Many interventions have been trialled to improve medication adherence. One promising innovation is the electronic personal health record (PHR). Objective: This systematic literature review aims to identify the important design features of PHR to improve medication adherence for patients with long term conditions. Methods: This protocol follows the PRISMA-P 2015 statement. The following databases will be searched for relevant articles: PubMed, Science Direct, BioMed Central, CINAHL, Cochrane Database of Systematic Reviews and the Cochrane Central Register of Controlled Trials. Studies published in English, in the last fifteen years will be included if they have participants who are adults treated outside the hospital, having the ability to self-administer their medication, with at least one long term condition. The review will exclude commercial or political sources and papers without references. Papers that research paediatrics, pregnant or terminally ill patients will also be excluded, since their medication management is typically more complex. Results: One reviewer will screen the included studies, extract the relevant data and assess the quality of evidence utilising the GRADE system and the risk of bias using the Cochrane RevMan tool. The second reviewer will quality assess 25% of the included studies to assess inter-rater agreement. Any disagreement will be solved by a third reviewer. Only studies of high and moderate quality will be included for narrative synthesis. Conclusions: NHS policy assumes that increasing usage of PHRs by citizens will reduce demand on healthcare services. There is limited evidence that the use of health apps can improve patient outcomes and to our knowledge this is the first systematic literature review aiming to identify important design features of the PHR that may improve medication adherence in the adult population with long term conditions. Clinical Trial: PROSPERO: CRD42017060542