Reading clinicians' consultation notes can improve patient adherence to medications.

A new study of patients reading the visit notes that their clinicians write and report positive effects on their use of prescription drugs. The study entitled "Patients Who Manage Their Drugs and Read Visit Notes: A Survey of OpenNotes Participants", published today in the Annals of Internal Medicine, shows that when patients read their notes, they report significant benefits, including feeling more comfortable with their medications, better understanding their side effects and being more likely to take medications as they do. have been prescribed.

The study was conducted online on approximately 20,000 adult patients at the Beth Israel Deaconess Medical Center in Boston (BIDMC) in Boston, at the University of Washington Medicine (UW) in Seattle and at Geisinger, in the United States. rural areas of Pennsylvania. The three health systems share visiting notes written by primary care physicians, surgical specialists and other clinicians for several years.

"Sharing clinical notes with patients is a relatively inexpensive and tactile intervention," said Catherine DesRoches, study director, DrPH, executive director of OpenNotes, and BIDMC's division of general medicine. "Sharing notes requires a change of culture in medicine, but this is not technically difficult with most electronic health record systems (EHRs), and could have a huge benefit, given that poor medication compliance costs about $ 300 billion a year, all of which we can do to improve adherence is very helpful. "

Patients reported significant benefit from reading their notes: 64% said they understood better why a drug was prescribed; 62% felt they had more control over their medications; 57% found answers to questions about drugs; and 61% felt more comfortable with the drugs. Fourteen percent of BIDMC and Geisinger patients said they were more likely to take their medications as prescribed after reading their notes, while 33% of UW patients felt that the ratings were very important to help them take their medication. The study also showed that patients speaking primary languages ​​other than English and those with a lower education level were more likely to report benefits.

"This type of seamless communication represents a big change in the long-standing practice, and it's not easy," said co-author of the study and co-founder of OpenNotes, Tom Delbanco, MD, MACP, John F. Keane and Professor of Family Medicine at Harvard. School of Medicine and BIDMC. "The doctors who are considering it for the first time are nervous, they are worried about many things, including potential effects on their workflow and the fear of their patients." But once they started , we know few doctors who have decided to stop and patients love it.The promise he holds for therapeutic compliance is huge, and we are really excited about these results. "

Study participants were 18 years of age or older, had been connected to the secure patient portal at least once in the last 12 months, had at least one ambulatory visit note available, and had received a prescription or taking medication in the last 12 months. Respondents to the survey were urban and rural, with varying levels of education and a broad age and race distribution. The key outcome measures included patient-reported behaviors and their perceptions of benefits versus risk.

In an accompanying editorial, David Blumenthal, MD and Melinda K. Abrams, a member of the Commonwealth Fund, write: "Transparency is no longer the distant and radical vision that existed when the pioneering OpenNotes team began its work.It is rather a fact the clinical life, mandated by federal laws and policies … Our challenge now is to make the best of shared information about health care as a # 39, clinical management tool and health improvement. "