Research AppraisalSystematic Review

Leveraging MedlinePlus to Improve Health Information Access Among Patients and Caregivers: Systematic Literature Review

JMIR medical informaticsYu, Fei, Wang, Xiaomeng, Liu, Jia et al.27 Apr 2026DOI

Clinical Snapshot

50CEBM
Evidence: WeakSystematic Review

PICO Framework

P — PopulationPatients and caregivers using MedlinePlus health information resource
I — InterventionMedlinePlus information interventions in various settings (clinical, community, online)
C — ComparatorNot clearly defined - most studies lacked control groups
O — OutcomesHealth information access, patient engagement, self-efficacy, clinical outcomes, health literacy measures

Bottom Line

This systematic review examined 28 studies on MedlinePlus integration in healthcare settings, finding predominantly positive effects on patient satisfaction and engagement but limited evidence for clinical outcomes. While methodologically sound in its approach, the review's clinical utility is constrained by geographic specificity (89% US studies), focus on process rather than clinical outcomes, and lack of quantitative synthesis. Only 4 studies assessed clinical outcomes with mixed results. The evidence suggests patient education resources can improve satisfaction and self-efficacy, but robust clinical benefit remains unproven. For Australian clinicians, the findings may inform development of similar patient education initiatives using local resources like healthdirect.gov.au, but direct application of MedlinePlus interventions is not feasible.

Evidence: Weak

Key Findings

  • P Value: Not applicable - no statistical pooling

  • Effect Size: Not quantified - narrative synthesis only

  • Primary Outcome: Health information access and patient engagement with MedlinePlus

  • Nnt Or Sensitivity: 24/28 studies (86%) reported positive non-clinical outcomes including improved satisfaction and self-efficacy

  • Confidence Interval: Not reported

Clinical Application

Low feasibility in Australian context due to resource specificity Limited relevance to Australian practice as MedlinePlus is US-specific. Australian equivalents include healthdirect.gov.au and Better Health Channel (Victoria). Findings may inform development of similar patient education resources but direct application not possible. Limited applicability - MedlinePlus is US National Library of Medicine resource

Abstract

BACKGROUND: MedlinePlus, developed by the National Library of Medicine (NLM) in the United States, is one of the most widely used, authoritative, consumer-grade health information resources on the web. Although extensively used and discussed in scholarly work for health literacy and patient education, it is unclear how MedlinePlus has been integrated into clinical care or embedded within health informatics applications. OBJECTIVE: This study aimed to understand how MedlinePlus has supported patients and caregivers by increasing access to health information for clinical care and illness management. The insights on this topic will inform the design and development of patient-facing digital health intervention tools for improved health communication, decision engagement, informed decision-making, and health outcomes. METHODS: We conducted a systematic literature review following the PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) guidelines. First, we developed a comprehensive literature search strategy, searched 9 citation databases, and aggregated and deduplicated search results before importing them into Covidence for manual screening using predefined inclusion and exclusion criteria. Second, reviewers independently assessed all studies at the title-abstract and full-text levels, resolving discrepancies through ongoing discussions. Third, we applied the PICO (problem/population, intervention, comparison, and outcome) and the Collaborative Chronic Care Model as guiding frameworks for data extraction and analysis. All included studies underwent quality assessment using the Mixed Methods Appraisal Tool. RESULTS: In total, 28 studies reported in 27 sources met our inclusion criteria. We categorized the extracted data into 4 areas. First, regarding bibliometrics, the studies were reported between 2004 and 2024, with 2010 having the highest number of studies. Of these studies, 25 were conducted in the United States, 2 were conducted in Iran, and 1 was conducted in Argentina. Health informatics journals and conference proceedings, as well as library science journals, were prominent publishing venues. The NLM funded half of the studies. Second, regarding participants, most studies focused on outpatients. Other participant roles included physicians, nurses, hospital staff, pharmacists, and librarians. Fewer than half of the studies addressed the social determinants of health. Third, regarding intervention, most studies implemented MedlinePlus information interventions within clinical settings. Other interventions occurred in community pharmacies, community organizations, libraries, online health platforms, or patient portals. Fourth, regarding outcome, only 4 studies assessed clinical outcomes, and the findings were mixed and inconsistent. However, 24 of 28 studies reported positive nonclinical outcomes, including improved attitudes toward and satisfaction with MedlinePlus and enhancements in patients' information-seeking behaviors, confidence, and willingness to engage in decision-making, physician-patient communication, self-management, and self-efficacy. CONCLUSIONS: This systematic literature review is the first comprehensive examination of how MedlinePlus has been integrated into clinical care, supporting patients and caregivers with enhanced access to health information. Our findings offer evidence and insights through the Collaborative Chronic Care Model lens and can guide the development of digital health interventions to improve patient health.

References

  1. 1.Yu, F., Wang, X., Liu, J., Wang, T., Grady, S. D., & Song, L. (2026). Leveraging MedlinePlus to Improve Health Information Access Among Patients and Caregivers: Systematic Literature Review. JMIR Medical Informatics, 14(1), e79416. https://doi.org/10.2196/79416
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