Fourteen studies, with 6,310 participants, were included in the review. The authors judged the quality of evidence to be low or very low; most included studies had a high risk of bias.
Diabetes (three studies, n=3,807 patients): All studies reported a small number of benefits for patient-held medical records. One study reported significant effects in favour of patient-held medical records for five out of 17 outcomes: receipt of foot examinations (OR 1.68; 95% CI 1.12 to 2.50); physical exercise advised (OR 1.84; 95% CI 1.16 to 2.92); smoking discussed or non smoking advised (OR 1.82; 95% CI 1.15 to 2.89); decrease in glycated haemoglobin (p<0.001) and a decrease in diastolic blood pressure (p<0.05). A second study reported significant effects in favour of patient-held medical records for seven out of 21 outcomes assessed: All benefits were for process indicators of checking glycated haemoglobin, creatinine, eye examination, cholesterol, weight or glucose within a certain time frame. The third study reported significant effects in favour of patient-held medical records in only two out of 19 outcomes assessed: decrease in glycated haemoglobin and body mass index.
Oncology (six studies, n=1,773 patients): Most outcomes measured by these studies showed no significant differences between groups with and without a patient-held medical record. One study found that patient-held medical record users felt less able to face future aspects of their illness (p=0.05); the only significant result of 22 outcomes measures. One study found that patient satisfaction with information received at the end of treatment was significantly greater in the control group (p=0.02); seven other outcome measures showed no significant difference. One study showed that fewer patient-held medical record users felt they needed more information about their disease and treatment (p≤0.05), but participants in the control group were less uncertain about tests, procedures and lifestyle issues (p≤0.05). One study showed that participants using a patient-held medical record found it less difficult to monitor their own progress (p=0.009) and were more likely to feel in control (p=0.03); however, 67 other measures in the same study found no significant differences.
Mental health (two studies, n=291 patients): No significant differences were identified in any outcome measure.
Rheumatoid arthritis (one study, n=141 patients): There were differences between groups in some of the eight process measures (visits to general practitioners, and physiotherapists' perceptions of co-ordination and continuity of care), but not in any other outcome measure.
Stroke (one study, n=252 patients): This study only reported data for 38% of recruited patients. Patient satisfaction was higher in the patient-held medical record group on three out of 16 measures. However, in the 23 measures of communication, the intervention group were less able to talk to staff or doctors about problems (p=0.01).
Palliative care (one study, n=46 patients): There were no significant differences between patient-held medical record and control groups for the five main outcome measures.