***TASK*** the task is to summarize an input biomedical literature in six sentences 
    ***INPUT*** the input is a biomedical literature 
    ***OUTPUT*** the output is the summary of an input biomedical literature in six sentences 
    ***DOCUMENTATION*** 
    ***EXAMPLES*** 
    Input: The objective of this study was to describe the attitudes of general practitioners ( GPs ) and their patients to  patient-held health records ( PHR ) .  The study was set in a general practice in South Australia . It consisted of a descriptive study using a mail question naire . A stratified r and om sample , based on socioeconomic indicators for areas in South Australia , of GPs ( n = 315 ) and their patients ( n = 500 ) was used . The indices for contents , problems and benefits of the PHR  showed adequate internal consistency and reliability . Patients mostly perceived the PHR as a personal document for reference while GPs perceived it as a management and communication tool . The solo GP who scored high on the ' PHR benefits ' and low on the ' PHR problems ' indices , and doubted that GPs were influential in changing patient behaviour would let patients keep full copies of their records . The younger female rural GP who scored high on the ' PHR benefits ' and low on the ' PHR problems ' indices favoured a patient summary . The more entrepreneurial GPs who scored high on both the ' PHR benefits ' and ' PHR problems ' indices favoured a ' censored summary ' . Awareness of smart cards was high and opinions on their use guarded . It was concluded that patients and doctors have different attitudes to and expectations of PHRs . Significant sociodemographic , educational and attitude correlations with PHRs were found . The ' PHR benefits ' and ' PHR problems ' indices were consistent , useful and may have a wider applicability in quantifying the opinion of patients and providers before implementing PHR programmes OBJECTIVE To evaluate the use of a multidisciplinary record held by patients with cancer in the community . DESIGN Pragmatic r and omised controlled trial . SETTING The environs of Swansea in south west Wales . PARTICIPANTS 501 patients under the care of the Department of Oncology , Singleton Hospital , Swansea . INTERVENTION A patient held record used by the patient and healthcare professionals . Main outcome measures -Health related quality of life ( EORTC QLQ-C30 ) measured at entry into the study and at 6 months ; patients ' views at 6 months ; healthcare professionals ' views collected after the completion of patient follow up ; NHS re source and booklet use . RESULTS 1148 patients were eligible for the study ; 501 were recruited ( 44 % ) and 344 completed the study ( 172 in each group ) . There was no significant difference between the two groups in change in quality of life or NHS re source use . The patient held record did not have an impact on communication but was significantly helpful to patients in preparing for appointments , reducing difficulties in monitoring their own progress , and helping them to feel more in control ( p<0.05 ) . Fifty three percent of patients would have preferred not to have a patient held record .  There was a low level of use of the record by healthcare professionals but most of those who remembered using it indicated that they would prefer patients to have it . CONCLUSIONS The patient held record is valued by some patients and professionals but has no significant impact on the quality of life of patients or NHS re source use . It has a positive impact on quality by helping patients feel more in control and prepare for meetings with healthcare staff . Patients who find it useful tend to be younger and have more professionals involved in their care . It is recommended that it should be made available to patients on request and used by them according to need AIM To investigate whether a comprehensive strategy involving both patients and professionals , with the introduction of a diabetes passport as a key component , improves diabetes care . METHODS The first 150 consecutive patients who visited their internist for a diabetes check up at the internal medicine outpatient departments at each of nine Dutch general hospitals were included in this 1 year clustered , r and omised , controlled trial . Health care professionals attended an educational meeting about the use and dissemination of the diabetes passport which is a patient held record . They also received aggregated feedback on baseline data and personal feedback . Educational meetings were also organised for patients . Patient files were used in conjunction with question naires to determine adherence rates . Data were analysed using multilevel regression analysis . RESULTS Small but significant changes were found in mean HbA1c levels . In the intervention group , positive health changes for patients were found ( -0.3 % ) when compared to those in the control group ( + 0.2 % ) . Diastolic blood pressure improved slightly , but no changes were found in systolic blood pressure or cholesterol . Improvements were found with regard to levels of examination of patients ' feet and in patient education . CONCLUSIONS Efforts to improve professional practice involving both professionals and patients led to small improvements in HbA1c and diastolic blood pressure levels . Further study is needed to establish whether a better structured health care delivery , operating in a more supportive environment can enhance these effects A logbook , or patient-dossier , was developed , to improve continuity of information in the treatment and care of head- and -neck cancer patients . It contained information modules on different aspects of care , as well as forms to facilitate communication both between patient and care-professional and between the various care-professionals . The logbook 's  effectiveness was evaluated in two hospitals in Rotterdam , by comparing outcomes for trial and comparison groups of , respectively , 71 and 54 patients and 59 and 35 care-professionals . Trial patients proved to be better informed , to receive more support and to experience fewer psychosocial problems . Professionals who used the logbook were better informed about their patients , and about the care-activities of fellow-professionals than those who did not . They recognised an improvement in their contact with colleagues and in the harmonisation of their respective care-activities Objectives : To evaluate prospect ively the introduction of a patient-held record ( PHR ) in the management of patients with advanced cancer and palliative care needs . Design : a ) A prospect i ve , parallel group , r and omized controlled trial . b ) A postal survey of the opinions of health professionals whose patients had a PHR .  Setting : Out-patient oncology centres in Glasgow and Edinburgh , hospice home-care services across the central belt in Scotl and . Participants : A total of 244 patients with advanced cancer recruited either from oncology out-patient clinics or hospice home-care services . The baseline interview was completed by 231 patients and 117 were r and omized to receive the PHR . Between 4 and 6 months later , 80 patients with the PHR and 97 without were interviewed . Of the 83 health professionals caring for patients known to have received the PHR 63 replied to a postal question naire . Main outcome measures : Subjective views of patient satisfaction with communication and perception of communication between patient and health care professionals as determined by structured interview at baseline and after 4– 6 months . Results : We could identify no improvement in the provision of information to patients , or patients ' satisfaction with information provided by out-patient doctors , GPs , practice and community nurses and hospice or palliative home care staff . Overall , patients ' perception of communication between all staff involved in their care with and without PHRs was excellent in 24 % and 21 % , respectively , or very good in 56 % and 58 % ( P=0.89 ) . The PHR made no difference to information passing between health professionals , or to the degree of family involvement . Most of those who had a record found it of some use and benefit . Conclusion : This study provides no evidence on which to base the widespread promotion of PHRs , although local projects with committed clinicians and patients may well prove popular and effective BACKGROUND The burden of cancer care in general practice is increasing . Patient-held records may facilitate effective , coordinated care , but no r and omised controlled trials of their use in cancer care have been conducted , and concerns about possible negative effects remain . AIM To evaluate the use of a supplementary patient-held record in cancer care . METHOD Six hundred and fifty radiotherapy out patients with any form of cancer were r and omised either to hold a supplementary record or to receive normal care . It was explained to record holders that the supplementary record was intended to improve communication with health professionals and act as an aide memoire . After three months , patients ' satisfaction with communication and with participation in their own care were assessed . Global health status , emotional functioning , and cognitive functioning were measured using the European Organization for Research and Treatment of Cancer QLQ-C30 question naire . RESULTS There were no significant differences between groups in any of the outcome measures . Patients in both groups expressed a high level of satisfaction with communication and participation in their care . Mean ( SD ) scores in the intervention and control groups were : global health status , 66.8 ( 24.2 ) and 65.3 ( 23.7 ) ; emotional functioning , 75.0 ( 24.6 ) and 77.4 ( 22.8 ) ; cognitive functioning , 84.5 ( 21.0 ) and 84.0 ( 21.3 ) . CONCLUSION A supplementary patient-held record for radiotherapy out patients appears to have no effect on satisfaction with communication , participation in care , or quality of life The objective of this study was to evaluate a patient-held record ( PHR ) for patients with cancer . A r and omized controlled trial ( RCT ) was conducted of a PHR to be used by patients newly diagnosed with lung or colorectal cancer ( hospital ) , patients with cancer at any stage ( community ) and professionals involved in their care , together with surveys of health professionals to gauge views on PHR . Main outcome measures were patient satisfaction with information and communication , and patient and healthcare professionals ' views of PHR .  The only significant difference was 86 % of control compared with 58 % of intervention patients were very satisfied with information received at the end of treatment ( odds ratio 4.4 , 95 % confidence interval 1.2 - 15.6 , P < 0.05 ) . Fifty-three per cent of intervention respondents found the  PHR helpful ( 63 % hospital vs. 38 % community patients ) , and 69 % felt that it would be useful to them in the future . Primary healthcare ( PHC ) professionals found the PHR of more benefit than those working in hospitals ( P < 0.05 ) . The PHR did not improve measures of patient satisfaction with information or communication . Despite its limited use by many health professionals , the PHR was well received by recently diagnosed patients , and those who did not receive negative responses to it from staff involved in their care . It was also positively valued by staff in PHC . An evaluation of a customized record provided at the time of diagnosis is warranted To assess a policy of women holding and thus having constant access to their own obstetric records , 290 women attending a peripheral consultant clinic in Newbury , West Berkshire , were r and omly allocated to hold either their full case notes , or the more usual co‐operation card . Women holding their full records were significantly more likely to feel in control of their antenatal care ( rate ratio 1·45 ; 95 % confidence interval 1·08–1·95 ) and to feel it was easier to talk to doctors and midwives ( rate ratio 1·73 ; 95 % confidence interval 1·16‐2·59 ) . No other beneficial effects were detected . Asked about their preferences for any subsequent pregnancies , women holding their own records in the index pregnancy were more likely to say they would prefer to hold the same kind of record again in a subsequent pregnancy than were women holding a co‐operation card ( rate ratio 1·56 ; 95 % confidence interval 1·34–1·81 ) . There was no evidence of negative effects . In particular , women holding their case notes did not feel more anxious than co‐operation card holders . The policy of women holding their notes result ed in savings in elerical time , without evidence of an increase in the rate of lost notes BACKGROUND Patient-held records can improve communication across the primary - secondary interface . There has been no previous rigorous assessment of the utility of patient-held records for people with schizophrenia from a primary care perspective and their value for this population is unclear . AIM To evaluate the effectiveness of a patient-held record for patients with schizophrenia receiving shared care . DESIGN OF STUDY Cluster r and omised controlled trial . SETTING Seventy-four general practice s and six community mental health localities in Birmingham , Engl and between June 1998 and June 1999 . METHOD A sample of 201 patients with schizophrenia ( ICD-10 classification F20 ) was recruited ; of these , 100 were intervention and 101 were control . Patient-held records were given to the intervention patients . At 12-month follow-up , all patients were accounted for and 191 ( 95 % ) were revisited . Primary outcomes were the Verona Service Satisfaction Scale-54 ( VSSS-54 ) and the Krawiecka and Goldberg ( K & G ) rating scale of psychopathology at 12-month follow-up . Secondary outcomes were use of primary and secondary care services . RESULTS A total of 63/92 ( 68.5 % ) patients still had the patient-held record , 64/92 ( 69.6 % ) had used it , and 39 ( 60.9 % ) of the 64 who had used it said the patient-held record was regularly used by their keyworker . However the patient-held record had no significant effect on primary outcomes ( VSSS-54 : F1,116 = 0.06 , P = 0.801 , K & G : F1,116 = 0.6 , P = 0.439 ) or on use of services . A higher symptom score was associated with not using the patient-held record . CONCLUSIONS The trial provides no good evidence to suggest that patient-held records should be introduced as part of routine shared care for all patients with schizophrenia . However , the patient-held record was acceptable to patients with schizophrenia and acted as a communication tool , particularly between patients and keyworkers BACKGROUND Few formalized shared care schemes exist within psychiatry and the evidence base for sharing psychiatric care is weak . AIMS To evaluate the utility of patient-held shared care records for individuals with long-term mental illness . METHOD Cluster-r and omised controlled parallel-group 12-month trial involving 9 
    Output:
    
In these studies the use and appreciation of PHRs  by patients is satisfactory .
The use and appreciation of the PHRs  by physicians in the studies is lower than the use by patients .
The most important obstacle for physicians is the time investment required .
A PHR for undocumented immigrants seems to be appropriate because in most cases there is no other record available .