Use of Personal Health Records to Support Diabetes Self-management: An Integrative Review

More than 30 million persons in the United States have diagnosed or undiagnosed diabetes. Persons with chronic types of diabetes must learn self-management principles and techniques and perform self-care behaviors to reduce the risk of diabetes-related complications. An electronic personal health record is one type of technology commonly used to support diabetes self-management. This integrative review examines research on how personal health records incorporate or address the American Association of Diabetes Educators self-care behaviors, diabetes-related psychosocial concerns, and the diabetes-related clinical quality-of-care measures of hemoglobin A1c, low-density lipoprotein cholesterol, and blood pressure. In the majority of studies reviewed, participants showed improvement in the self-care behavior or physiological outcome examined. Findings were inconclusive about the impact of personal health record use on diabetes distress. Results also revealed a lack evidence of patient specific factors influencing intention to use a personal health record for management of type 2 diabetes mellitus. Despite evidence that personal health record use improves diabetes self-management, they are underutilized. Implications for practice include understanding what influences intention to use a personal health record. Further research is also needed to determine the impact of personal health record use on diabetes distress.