PROMOTING PREVENTIVE CARE WITH PATIENT-HELD MINIRECORDS - A REVIEW

Introduction: Although patient involvement is essential for the success of all types of preventive care, patient involvement in clinical prevention has been limited Patient-held minirecords have recently received support from public health authorities, providers and the public as a means to improve patient involvement in preventive care for adults. This paper reviews the history and current developments in patient-held minirecord use for preventive care. Methods: A literature review was performed using sources obtained from electronically, searching the Medline database from 1966 to the present and using reference lists to obtain secondary sources. The author's collection of privately and governmentally produced minirecords was also utilized. Findings: Patient-held minirecords have been widely and successfully employed to improve preventive care for children, particularly with regard to immunizations. They have not been widely used to promote adult preventive care. Several clinical trials have found that their use can lead to unproved preventive care for the general adult population. Potential advantages of patient-held minirecords include: improved performance rates of preventive care, improved continuity of preventive care, low cost and improved practice promotion for prevention-oriented providers. Potential barriers to the use of patient-held minirecords include: the traditional power relationship of physicians and patients, physicians' reticence to share records with patients and time and effort costs. The optimal characteristics of a patient-held minirecord for adult preventive care remain to be delineated by research and evaluation. Significance: A patient-held minirecord is an inexpensive, practical intervention that can help build patient involvement and improve the quality of preventive care for adults as well as children.