A Personal Health Record for patients with multiple sclerosis: A 2-year evaluation study

Abstract

Abstract Background Multiple sclerosis (MS) is a chronic disease impacting the central nervous system, affecting 2.8 million people worldwide. Effective self-management is crucial for treating chronic diseases, including MS. Personal health records (PHRs) show promise in supporting self-management, potentially empowering patients and enhancing their engagement in treatment and health. However, implementation challenges persist. Objectives This study aimed to) assess the feasibility and usability of the PHR according to patients and healthcare professionals (HCPs), and 2) evaluate implementation determinants, and exploring preliminary effects on a range of outcomes related to the quality, efficiency, and costs of care, as well as health-related outcomes. Methods A mixed-methods study was conducted in a Dutch hospital. Quantitative data from 80 patients and 12 HCPs were collected via questionnaires at baseline (T0), after one (T1) and 2 years (T2). Focus group interview were conducted at T2 with 7 patients and 4 HCPs. Results Most patients never logged in during the first year and logged in a couple of times during the second year, with 15 minutes per log-in session. The HCPs mainly logged in a couple of times per year, averaging six minutes per session. Patients’ and HCPs’ usability and satisfaction scores were below average and moderate respectively. Various facilitators and barriers were identified, including knowledge gaps, staff capacity issues, and ICT obstacles. No significant differences were found in preliminary effects. Qualitative data highlighted benefits in terms of gaining insight into health data but revealed challenges with log-in issues and information retrieval. Conclusions Implementation challenges hindered PHR adoption. The evolving nature of PHRs requires ongoing evaluation and adaptation to optimize their potential benefits. Utilizing a participatory design approach and a dedicated implementation team could enhance adoption and maximize benefits. Key messages • A personal health record (PHR) for patients with MS was evaluated within the care setting of a Dutch hospital, demonstrating limited usability and moderate satisfaction. • Diverse obstacles impeded the adoption and uptake of the PHR, but potential solutions lie in continuous development with a participatory design approach and dedicated implementation team.