期刊文章@ 1438- 8871% I JMIR出版公司通过电子门户分卡塔尔世界杯8强波胆分析享医生笔记与改善药物依从性有关:准实验研究%A Wright,Eric %A Darer,Jonathan %A Tang,Xiaoqin %A Thompson,Jason %A Tusing,Lorraine %A Fossa,Alan %A Delbanco,Tom %A Ngo,Long %A Walker,Jan %+ Geisinger卫生系统，健康研究中心，100 N Academy Ave，丹维尔，PA, 17822，美国，1 5707146633,eawright@geisinger.edu %K患者门户%K依从性%K病程记录%K高血压%K高血脂%D 2015 %7 08.10.2015 %9原始论文%J J Med Internet Res %G英文%X背景:在调查、访谈和焦点小组中，服用药物并提供Web门户访问其初级保健医生(pcp)笔记的患者报告了对其方案的依从性改善。然而，客观的证实还有待报道。目的:评估患者互联网门户访问初级保健医生就诊记录和药物依从性之间的关系。方法:本研究是在OpenNotes准实验试验的一个地点进行回顾性比较分析。环境包括在宾夕法尼亚州丹维尔的盖辛格卫生系统(GHS)的初级保健实践。参与者包括在2009年3月至2011年6月期间服用至少一种抗高血压或抗高脂血症药物的18岁或以上的电子门户访问、GHS初级保健医生和盖辛格健康计划保险的患者。从2010年3月开始，干预患者被邀请并被提醒阅读他们的pcp笔记。对照组患者也可以访问整个门户网站，但他们的pcp记录是不可用的。 From prescription claims, adherence was assessed by using the proportion of days covered (PDC). Patients with a PDC ≥.80 were considered adherent and were compared across groups using generalized linear models. Results: A total of 2147 patients (756 intervention participants, 35.21%; 1391 controls, 64.79%) were included in the analysis. Compared to those without access, patients invited to review notes were more adherent to antihypertensive medications—adherence rate 79.7% for intervention versus 75.3% for control group; adjusted risk ratio, 1.06 (95% CI 1.00-1.12). Adherence was similar among patient groups taking antihyperlipidemic agents—adherence rate 77.6% for intervention versus 77.3% for control group; adjusted risk ratio, 1.01 (95% CI 0.95-1.07). Conclusions: Availability of notes following PCP visits was associated with improved adherence by patients prescribed antihypertensive, but not antihyperlipidemic, medications. As the use of fully transparent records spreads, patients invited to read their clinicians’ notes may modify their behaviors in clinically valuable ways. %M 26449757 %R 10.2196/jmir.4872 %U //www.mybigtv.com/2015/10/e226/ %U https://doi.org/10.2196/jmir.4872 %U http://www.ncbi.nlm.nih.gov/pubmed/26449757