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Research: Access to Docs' Notes Increases Medication Adherence

November 4, 2015
by Rajiv Leventhal
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Researchers at the Danville, Pa.-based Geisinger Health System have found that patient access via a web portal to their doctors' notes is associated with improved adherence to a medication regimen.

Geisinger says this is the first large-scale study to show that access to doctors' notes helps patients take their medicines as prescribed. Specifically, among patients with access to notes from their primary care doctor, 79.7 percent were adherent to antihypertensive medications in contrast to only 75.3 percent of controls. While patient access to doctors' notes did not appear to influence adherence to antihyperlipidemic medications, participating doctors pointed to a number of documentation issues that may explain those findings.

For the study, appearing in the Journal of Medical Internet Research, Geisinger researchers analyzed data from 2,147 adult patients who took at least one blood pressure or cholesterol medication from March 2009 to June 2011.These medications are widely prescribed for common conditions such as high blood pressure and high cholesterol.

Geisinger was one of three leading healthcare organizations that first participated in the OpenNotes movement beginning in 2010; each of the three sites was part of a 12-month study to explore how sharing doctors’ notes may affect healthcare. Patients reported feeling more in control of their health, being better prepared for their visits and several other benefits. Doctors saw little or no impact on their work flow. In the five years since the launch of the study, the number of patients who are able to read their visit notes has grown to more than five million nationwide.

What’s more, researchers from Boston-based Beth Israel Deaconess Medical Center, another of the three original OpenNotes organizations, (BIDMC) recently found that this kind of patient engagement has the power to improve safety and quality of care. In that research, patients said, among other things, that their doctors' notes helped them remember to take their medications better and recall more of what happened during office visits. Some noticed errors in their records that were subsequently corrected. Others read the notes and were reminded to follow up on clinically significant appointments

The feedback at Geisinger has been similar. "Providing patients access to their doctors' notes and reminding them to read them before visiting their doctor is key to reinforcing the doctors' rationale for prescribing specific medications and dosage," explained Eric A. Wright, Pharm.D., a research investigator at Geisinger's Center for Health Research, associate professor of pharmacy practice at Wilkes University, Wilkes-Barre, and the study's lead investigator. "We demonstrated that encouraging patients to utilize a web portal to view their doctors' notes is a cost effective and efficient way to influence medication-taking behavior. Based on this study and our prior OpenNotes reports, increasing patient access to fully transparent doctors' notes should be on the radar screen of all healthcare providers," he added.

According to national studies, increasing medication adherence improves patients' overall health while reducing their use of healthcare services, such as hospitals, which leads to a lower overall cost of care. Some experts estimate that medication non-adherence costs the U.S. $100 billion per year in excess healthcare costs. Most importantly, non-adherence causes 30 to 50 percent of treatment failures and 125,000 deaths annually, according to the Consumer Health Information Corporation.

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