***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: 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 AIMS To assess the efficacy ( change in HbA1c ) of a patient-held communication , self-empowerment and educational device for people with diabetes  ( the New Zeal and Diabetes Passport ) in patients with poor glycaemic control . RESEARCH DESIGN AND METHODS A 12-month , multicentre , general practice -based r and omized controlled trial in urban , provincial and rural New Zeal and involving 398 people with poorly controlled Type 1 or Type 2 diabetes . The intervention included a specifically design ed and piloted New Zeal and Diabetes Passport including information relating to diabetes knowledge , self- assessment s , and guidance concerning how to engage with diabetes health professionals . The primary end point was change in HbA1c . Assessment s were made at 0 , 6 and 12 months . RESULTS Two hundred and twenty-two patients received the Passport , 176 the control booklet , coming from 69 and 66 general practitioners , respectively . Use of the Passport was associated with a relative reduction in HbA1c of 0.4 % ( P = 0.017 ) and a relative increase in weight of 1.0 kg/m2 ( P = 0.028 ) , but no changes in diabetes knowledge , attitudes to diabetes or risk factors for diabetic tissue damage . CONCLUSIONS The dissemination of the New Zeal and Diabetes Passport , in isolation , was not associated with improvements in either diabetes knowledge or self-empowerment . While a small improvement in glycaemic control occurred , this was probably due to changes in insulin therapy in the intervention group . It is possible that linking the use of the Passport with other behavioural and educational interventions may make the Passport more useful . Further study is required to confirm the effect of such multifaceted interventions Background Stroke patients ' care in hospital tends to be poorly organised , with poor communication and a lack of information being frequent sources of complaint . The purpose of this study was to evaluate whether a patient-held record ( PHR ) would result in greater patient satisfaction and better care planning for stroke patients . Methods A time series control ( 6 months ) - intervention ( 8 months ) - control ( 6 months ) was used among London teaching hospital general medical and geriatric medicine inpatient wards . All stroke patients admitted to the wards during the intervention phase received a PHR and were instructed in its use .  Demographic , stroke severity , social factors and outcomes were collected from all stroke patients during all phases of the study . Results Of 252 stroke patients aged 46 to 98 years entered into the study , by six months after admission 118 ( 46.8 % ) had died . PHR and control group patients were well matched in terms of socio-demographic characteristics and pre-stroke ability . At six months after admission , 119 ( 97 % ) patients responded to the question naire . Just over half ( 56 % , 13 ) of intervention group patients recalled receiving a PHR .  Of those patients , 59 % reported reading the PHR , 27 % had lost their PHR , and two-thirds said they had difficulties encouraging staff to write in the PHR . Half felt that possession of the PHR was more trouble than it was worth . PHR group patients were more satisfied with the recovery they had made ( 79 % vs. 59 % , p=0.04 ) , but felt less able to talk to staff about their problems ( 61 % vs. 82 % , p=0.02 ) . PHR group patients reported receiving fewer explanations about their condition ( 18 % vs. 33 % , p=0.12 ) and treatment ( 26 % vs. 45 % , p=0.07 ) , and were more afraid of asking doctors questions ( 21 % vs. 4 % , p=0.01 ) than controls . PHR group patients were no better prepared for hospital discharge than control group patients , and both groups were ill-informed about services and benefits that might have helped after discharge from hospital . Conclusions Stroke patients received poor information and explanations regardless of whether they received a PHR . A PHR did not appear to improve patient satisfaction or discharge planning , and may have reduced opportunities for communication and explanation 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 Objective . To study the effects of a parent-held child health record ( PHCHR ) that was created by the Norwegian Board of Health with the purpose of introducing this to the whole country . Design . R and omized controlled trial . Setting . Maternal and child health centres in 10 municipalities in Norway . Subjects . Parents of 309 children attending the National Preschool Health Surveillance Programme . Intervention . Half of the parents were given a PHCHR and short instructions on how it was expected to be used . Main outcome measures . Parent – professional collaboration , healthcare utilization , and parents ’ knowledge about child health matters and illness . Results . Some 73 % of the intervention group used the PHCHR regularly when visiting the health centres , 79 % reported that their own writing in the record was helpful , and 92 % favoured the PHCHR being permanently adopted . Use of the record did not influence the utilization of healthcare services , parents ’ knowledge of their child 's health , or parents ’ satisfaction with information or communication with professionals . Conclusions . The PHCHR was well accepted by parents and professionals but it had no effects on collaboration , healthcare utilization , or other measures that could justify the costs of introducing the record into common use . Therefore , the introduction of a parent-held child health record in Norway is being postponed 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 
    Output:
    
These studies do not demonstrate a significant benefit of introducing PHR .