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Using a Patient Internet Portal to Prevent Adverse Drug Events: A Randomized, Controlled Trial

Weingart, Saul N. MD, PhD*†‡; Carbo, Alexander MD†‡; Tess, Anjala MD†‡; Chiappetta, Laurel MS*; Tutkus, Sherri RN; Morway, Laurinda MEd*; Toth, Maria MD; Davis, Roger B. ScD†‡; Phillips, Russell S. MD†‡; Bates, David W. MD, MSc‡§

doi: 10.1097/PTS.0b013e31829e4b95
Original Articles

Objectives: Adverse drug events (ADEs) are common in ambulatory care and may result from poor patient-physician communication about medication-related symptoms. A module was developed within an electronic patient portal that was designed to enhance communication about medication symptoms and, in turn, reduce ADEs and health-care utilization.

Methods: The researchers conducted a randomized, controlled clinical trial of MedCheck, an automated electronic message generated in a patient Internet portal. MedCheck asked intervention patients if they had filled a recent prescription and if they had experienced any problems with the medication. Patients’ responses were forwarded automatically to primary care physicians. The study enrolled 375 intervention patients and 363 controls. After 3 months, the investigators reviewed patients’ medical records and conducted telephone interviews to identify ADEs and to assess health-care utilization.

Results: Among the 375 intervention patients, 184 (49%) responded to at least 1 MedCheck message. Patients reported 52 unfilled prescriptions and 56 medication problems. Patients responded to 72% of messages within 1 day. There was no statistically significant difference between intervention and control groups in the rate of ADEs, preventable or ameliorable ADEs, serious ADEs, or in subjects’ health-care utilization.

Conclusions: Internet portals have the potential to enhance patient-physician communication. However, additional development is required to demonstrate that such interventions can improve medication safety or health-care utilization.

ClinicalTrials.gov NCT00140504

From the *Center for Patient Safety, Dana-Farber Cancer Institute; †Division of General Medicine and Primary Care, Beth Israel Deaconess Medical Center; ‡Harvard Medical School; and §Division of General Internal Medicine, Brigham and Women’s Hospital, Boston, Massachusetts.

Correspondence: Saul N. Weingart, MD, PhD, Tufts Medical Center, 800 Washington Street, Boston, MA 02111 (email: sweingart@tuftsmedicalcenter.org).

The authors disclose no conflict of interest.

This study was supported by a clinical scientist career development award from the U.S. Agency for Healthcare Research and Quality (K08 HS11644) and a grant from Blue Cross Blue Shield of Massachusetts. The funders had no role in the design and conduct of the study; collection, management, analysis and interpretation of the data; and preparation, review, or approval of the manuscript.

Dr. Weingart had full access to all of the data in the study and takes responsibility for the integrity of the data and the accuracy of the data analysis.

© 2013 by Lippincott Williams & Wilkins