Use of electronic personal health records (PHRs) for complementary and alternative medicine (CAM) disclosure: Implications for integrative health care

Objectives: To test a hypothesis that patients' use of Internet-based personal health records (PHRs) will be positively related to their disclosure of their CAM use to medical doctors, controlling for covariates' effects (e.g., health, human capital, and demographics), and to examine the factors influencing patients' CAM use disclosures. Design: Cross-sectional survey. Methods: We analyzed data in a subsample of CAM users who used both the internet and healthcare services (n = 1457) from the Health Information National Trends Survey, a nationally representative study of U.S. adults (>= 18), by using a multivariate logistic analysis. Results: Among the subsample, 52.7% disclosed their use of CAM to their doctors and 19.3% used PHRs. Both the bivariate (64.1% vs. 35.9%, p < 0.01) and multivariate ((beta=0.558, SE = 0.220, OR = 1.75, p < 0.05) analyses revealed a positive relationship between PHR use and CAM use disclosure. Other significant factors for CAM use disclosure included being older, being a female, having insurance, and having regular source of care. Particularly, foreign-born adults had significantly lower odds of disclosing their CAM use than U.S.-born adults. Conclusions: We found that patients' PHR use facilitated their disclosure of CAM use to medical doctors. To ensure integrative healthcare and integrative medicine in the healthcare sector and optimum care for patients, education for CAM users regarding PHR adoption is encouraged. Next-generation PHR designs should consider incorporating domains for CAM data that allow patients to store CAM data and also incorporating 'intelligent' PHRs, whose contents can be converted into the patient's first language. (C) 2016 Elsevier Ltd. All rights reserved.