Evaluation of the Patient Activated Learning System (PALS) to improve knowledge acquisition, retention, and medication decision making among hypertensive adults: Results of a pilot randomized controlled trial

Abstract Background There are few engaging, patient centered, and reliable e-Health sources, particularly for patients with low health literacy. Objectives We tested the Patient Activated Learning System (PALS) against WebMD . We hypothesized that participants using PALS would have higher knowledge scores, greater perceived learning, comfort, and trust than participants using WebMD . Methods Participants with hypertension from an urban Internal Medicine practice were randomized to view 5 web pages in PALS or WebMD containing information about chlorthalidone. We assessed knowledge, learning perceptions, comfort, and trust through surveys immediately and one week following the intervention. Results 104 participants completed both survey sets (PALS = 51, WebMD  = 53). Immediate post intervention mean knowledge scores were higher for the PALS participants [(4.33 vs. 3.62 ( P = .003)]. A greater proportion of PALS participants answered ≥4/5 questions correctly (82% vs. 57%; IRR 1.46 [95% CI 1.13–1.89]). A greater proportion of PALS participants agreed they would feel comfortable taking chlorthalidone if prescribed to them (73% vs. 55%; IRR 1.38 [95% CI 1.04–1.84]). One-week recall and trust were similar in the two groups. Conclusions PALS may have advantages over WebMD for immediate knowledge acquisition, perceived learning, and comfort. Implications PALS is a promising new approach to eHealth patient education. ClinicalTrials.gov registration identifier: NCT03156634