%0期刊文章%@ 1438- 8871% I JMIR出版物%V 20卡塔尔世界杯8强波胆分析% N 7% P e235% T患者在线获取计算机化医疗记录和服务对2型糖尿病的影响:系统回顾%A Mold,Freda %A Raleigh,Mary %A Alharbi,Nouf Sahal %A de Lusignan,Simon +萨里大学健康与医学科学学院，肯特公爵大楼，吉尔福德，GU2 7XH，英国，44 01483 684636,freda.mold@surrey.ac.uk %K病历%K在线访问%K在线服务%K病历系统，计算机化%K计算机%K初级保健%K 2型糖尿病%D 2018年%7 06.07.2018年%9回顾%J J医学互联网Res %G英文%X背景:在线访问计算机化医疗记录有可能提高患者的便利性、满意度和护理，并促进更有效的组织和提供护理。目的:本综述的目的是探讨在初级保健中对2型糖尿病患者在线获取计算机化医疗记录和服务的使用和影响。方法:检索2004 - 2016年Medline、Embase、CINAHL、PsycINFO、Cochrane Library等多个国际数据库。虽然我们对每项研究都采用了详细的纳入和排除标准，但对研究设计没有限制。采用专题分析来综合证据。采用混合方法评价工具对研究质量进行评价。结果:检索确定了917项研究，其中28项被纳入。确定了五个主题:(1)年龄、性别、种族、教育程度和合并症数量的差异，全职工作的年轻男性使用这些服务最多; (2) improved health outcomes: glycemic control was improved, but blood pressure results were mixed; (3) self-management support from improved self-care and shared management occurred especially soon after diagnosis and when complications emerged. There was a generally positive effect on physician-patient relationships; (4) accessibility: patients valued more convenient access when online access to computerized medical records and services work; and (5) technical challenges, barriers to use, and system features that impacted patient and physician use. The Mixed Methods Appraisal Toolkit rated 3 studies as 100%, 19 studies as 75%, 4 studies as 50%, and 1 study scored only 25%. Conclusions: Patients valued online access to computerized medical records and services, although in its current state of development it may increase disparities. Online access to computerized medical records appears to be safe and is associated with improved glycemic control, but there was a lack of rigorous evidence in terms of positive health outcomes for other complications, such as blood pressure. Patients remain concerned about how these systems work, the rules, and timeliness of using these systems. %M 29980499 %R 10.2196/jmir.7858 %U //www.mybigtv.com/2018/7/e235/ %U https://doi.org/10.2196/jmir.7858 %U http://www.ncbi.nlm.nih.gov/pubmed/29980499