Original Paper

AIDS and Behavior

, Volume 17, Issue 9, pp 3091-3100

Personal Health Record Use and Its Association with Antiretroviral Adherence: Survey and Medical Record Data from 1871 US Veterans Infected with HIV

  • Keith McInnes D. Affiliated withVA QUERI Program and VA New England Healthcare System, Bedford VA Medical CenterBoston University School of Public Health Email author 
  • , Stephanie L. ShimadaAffiliated withVA QUERI Program and VA New England Healthcare System, Bedford VA Medical CenterBoston University School of Public Health
  • , Sowmya R. RaoAffiliated withVA QUERI Program and VA New England Healthcare System, Bedford VA Medical CenterDepartment of Quantitative Health Sciences, University of Massachusetts Medical School
  • , Ann QuillAffiliated withVA QUERI Program and VA New England Healthcare System, Bedford VA Medical Center
  • , Mona DuggalAffiliated withYale University School of Medicine
  • , Allen L. GiffordAffiliated withVA QUERI Program and VA New England Healthcare System, Bedford VA Medical CenterBoston University Schools of Medicine and Public Health
  • , Cynthia A. BrandtAffiliated withYale University School of MedicineVA Connecticut Healthcare System
  • , Thomas K. HoustonAffiliated withVA QUERI Program and VA New England Healthcare System, Bedford VA Medical CenterDepartment of Quantitative Health Sciences, University of Massachusetts Medical School
  • , Michael E. OhlAffiliated withIowa City VAMCUniversity of Iowa Hospitals and Clinics
    • , Kirsha S. GordonAffiliated withYale University School of MedicineVA Connecticut Healthcare System
    • , Kristin M. MattocksAffiliated withVA Central Western Massachusetts Healthcare System
    • , Lewis E. KazisAffiliated withVA QUERI Program and VA New England Healthcare System, Bedford VA Medical CenterBoston University School of Public Health
    • , Amy C. JusticeAffiliated withYale University School of MedicineVA Connecticut Healthcare System

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Abstract

Patient electronic personal health record (PHR) use has been associated with improved patient outcomes in diabetes and depression care. Little is known about the effect of PHR use on HIV care processes and outcomes. We evaluated whether there was an association between patient PHR use and antiretroviral adherence. Data came from the Veterans Aging Cohort Study and included cross-sectional survey and medical record data from 1871 HIV+ veterans. Our adherence measure was an antiretroviral medication possession ratio, dichotomized at 0.90, and based on pharmacy refill data. In our sample 44 % did not use the internet, 14 % used internet but not for health, 27 % used internet for health but not the PHR, and 14 % used the PHR. In multivariable analysis PHR use was associated with ≥90 % adherence after controlling for socio-demographic variables. Findings provide support for longitudinal studies and studies that identify which PHR functions (e.g. online medication refills, viewing lab results, secure messaging with providers) are most closely associated with medication adherence.

Keywords

HIV Medication adherence Health informatics Internet Personal health record Veterans