Clinical Edge

Summaries of Must-Read Clinical Literature, Guidelines, and FDA Actions

Sharing Notes With Patients Improves Medication Comprehension

Key clinical point: A study suggests that allowing patients to read their physician’s notes may help many them better manage and adhere to medications.

Major finding: At two health care sites, 14% of patients reported that reading their notes made them more likely to take their medications as prescribed. At a third site, 33% of patients rated notes as “extremely important” in assisting with medication regimens.

Study details: An online survey of 19,411 patients at three health systems.

Disclosures: Authors reported grant support by the Robert Wood Johnson Foundation, the Gordon and Betty Moore Foundation, the Cambia Foundation, and the Peterson Center on Healthcare.


Delbanco et al. Ann Intern Med. 2019 May 28. doi: 10.7326/M18-3197.


The study by Delbanco et al. demonstrates the value in sharing clinical notes with patients and builds upon previous findings that such transparency can enhance patient understanding and compliance, according to David Blumenthal, MD, and Melinda K. Abrams, MS, of the Commonwealth Fund.

While the study highlights the importance of openness among medical practices, more work is needed to ensure transparency can take place on a broader level, Dr. Blumenthal and Ms. Abrams wrote in an editorial accompanying the Delbanco study. These efforts should include more medical education about information sharing at the undergraduate, graduate, and postgraduate levels as well as stronger privacy protocols at practices and health care organizations, the authors wrote.

Health care providers also need to work with technology companies to create consumer-facing applications that enable patients to better understand their health information and use the data to take better care of themselves, according to the editorial.

“Assisting patients in the choice and use of these applications will often fall to clinicians,” the authors wrote. “Some applications may let patients participate in amending their own records. The OpenNotes team, with support from the Commonwealth Fund, is developing an approach called OurNotes that enables patients to modify their physician’s visit notes – in effect, to cogenerate such documents.”

The authors noted that more work remains in the gathering health information from nontraditional sources like social media, wearables, and mobile devices and integrating these mediums into the formal clinical record. Additionally, disparities in the ability of different patient populations to consume health care data needs to be addressed.

The authors concluded by saying that, ready or not, health care professionals are living in an age of mass transparency. The challenge for physicians is to make the best of such shared health information by using it as a tool for health improvement.

Dr. Blumenthal is President of the Commonwealth Fund and Ms. Abrams is vice president for the Commonwealth Fund. They made these comments in an editorial that accompanied the Delbanco et al. study in the Annals of Internal Medicine (2019 May 28. doi: 10.7326/M19-1366). The authors disclosed no conflicts of interest.