Article Text

Original research
Systematic review on the use of patient-held health records in low-income and middle-income countries
  1. Linju Joseph1,2,
  2. Anna Lavis1,
  3. Sheila Greenfield1,
  4. Dona Boban3,
  5. Claire Humphries4,
  6. Prinu Jose5,
  7. Panniyammakal Jeemon6,
  8. Semira Manaseki-Holland7
  1. 1Institute of Applied Health Research, University of Birmingham Edgbaston Campus, Birmingham, UK
  2. 2Centre for Chronic Disease Control, Delhi, India
  3. 3Amrita Institute of Medical Sciences, Cochin, India
  4. 4Birmingham City Council, Birmingham, UK
  5. 5Public Health Foundation of India, New Delhi, India
  6. 6Sree Chitra Tirunal Institute for Medical Sciences and Technology, Thiruvananthapuram, India
  7. 7Department of Public Health, Epidemiology and Biostatistics, University of Birmingham Edgbaston Campus, Birmingham, UK
  1. Correspondence to Dr Semira Manaseki-Holland; s.manasekiholland{at}bham.ac.uk

Abstract

Objective To review the available evidence on the benefit of patient-held health records (PHRs), other than maternal and child health records, for improving the availability of medical information for handover communication between healthcare providers (HCPs) and/or between HCPs and patients in low-income and middle-income countries (LMICs).

Methods The literature searches were conducted in PubMed, EMBASE, CINAHL databases for manuscripts without any restrictions on dates/language. Additionally, articles were located through citation checking using previous systematic reviews and a grey literature search by contacting experts, searching of the WHO website and Google Scholar.

Results Six observational studies in four LMICs met the inclusion criteria. However, no studies reported on health outcomes after using PHRs. Studies in the review reported patients’ experience of carrying the records to HCPs (n=3), quality of information available to HCPs (n=1) and the utility of these records to patients (n=6) and HCPs (n=4). Most patients carry PHRs to healthcare visits. One study assessed the completeness of clinical handover information and found that only 41% (161/395) of PHRs were complete with respect to key information on diagnosis, treatment and follow-up. No protocols or guidelines for HCPs were reported for use of PHRs. The HCPs perceived the use of PHRs improved medical information availability from other HCPs. From the patient perspective, PHRs functioned as documented source of information about their own condition.

Conclusion Limited data on existing PHRs make their benefits for improving health outcomes in LMICs uncertain. This knowledge gap calls for research on understanding the dynamics and outcomes of PHR use by patients and HCPs and in health systems interventions.

PROSPERO registration number CRD42019139365.

  • quality in health care
  • public health
  • international health services

Data availability statement

Data sharing not applicable as no datasets generated and/or analysed for this study. All data relevant to the study are included in the article or uploaded as online supplemental information. All data underlying the results are available as part of the article and no additional source data are required.

http://creativecommons.org/licenses/by-nc/4.0/

This is an open access article distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited, appropriate credit is given, any changes made indicated, and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/.

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Data availability statement

Data sharing not applicable as no datasets generated and/or analysed for this study. All data relevant to the study are included in the article or uploaded as online supplemental information. All data underlying the results are available as part of the article and no additional source data are required.

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Footnotes

  • Contributors LJ, PJe, SG and SM-H conceived the article. LJ performed the literature search. LJ, DB, PJo collected data from individual studies and interpreted the data. LJ wrote the first draft of the paper. SM-H, SG, PJe, AL and CH revised the first and subsequent drafts. All authors contributed to interpretation of the findings and revised the manuscript for important intellectual content.

  • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

  • Competing interests None declared.

  • Provenance and peer review Not commissioned; externally peer reviewed.

  • Supplemental material This content has been supplied by the author(s). It has not been vetted by BMJ Publishing Group Limited (BMJ) and may not have been peer-reviewed. Any opinions or recommendations discussed are solely those of the author(s) and are not endorsed by BMJ. BMJ disclaims all liability and responsibility arising from any reliance placed on the content. Where the content includes any translated material, BMJ does not warrant the accuracy and reliability of the translations (including but not limited to local regulations, clinical guidelines, terminology, drug names and drug dosages), and is not responsible for any error and/or omissions arising from translation and adaptation or otherwise.