Ran Sun1, Lora E Burke2, Mary T Korytkowski3, Melissa I Saul4, Dan Li2, Susan M Sereika2. 1. Department of Health & Community Systems, University of Pittsburgh School of Nursing, 3500 Victoria St, Pittsburgh, PA 15213, USA. Electronic address: ras186@pitt.edu. 2. Department of Health & Community Systems, University of Pittsburgh School of Nursing, 3500 Victoria St, Pittsburgh, PA 15213, USA. 3. Department of Medicine, University of Pittsburgh School of Medicine, 3550 Terrace St, Pittsburgh, PA 15213, USA. 4. University of Pittsburgh School of Health and Rehabilitation Sciences, 3600 Atwood St, Pittsburgh, PA 15260, USA.
Abstract
AIM: This study examined glycemia level over a 2-year period between portal users and non-users. METHODS: This retrospective cohort study used data from electronic health records (EHRs) of a large academic medical center and its ancillary patient portal. A total of 15,528 patients with uncontrolled type 2 diabetes mellitus (T2DM) were included. Using propensity score matching (PSM), portal users and non-users were balanced on demographic and clinical characteristics. Mixed-effects polynomial regression modeling was employed to evaluate the HbA1c change over time between groups. RESULTS: The patient sample was 85.9% (13,333) white and 52.5% (7375) male. On average, patients were 62.8 (SD, 11.7) years old and with obesity (mean BMI: 34.2 ± 7.2 kg/m2) with uncontrolled T2DM (initial HbA1c: 8.5 ± 1.5%). After PSM, portal users (n = 4924) and non-users (n = 4924) were matched on all variables except for the insurance. The mixed-effects modeling showed a nonlinear decrease of HbA1c in both groups over time. A significant interaction was observed with a greater decline, followed by a smaller rise of HbA1c in portal users than non-users. CONCLUSIONS: The use of the patient portal was significantly associated with a lower HbA1c. This finding supports patient portals as a promising tool for improving clinical outcomes in patients with uncontrolled T2DM.
AIM: This study examined glycemia level over a 2-year period between portal users and non-users. METHODS: This retrospective cohort study used data from electronic health records (EHRs) of a large academic medical center and its ancillary patient portal. A total of 15,528 patients with uncontrolled type 2 diabetes mellitus (T2DM) were included. Using propensity score matching (PSM), portal users and non-users were balanced on demographic and clinical characteristics. Mixed-effects polynomial regression modeling was employed to evaluate the HbA1c change over time between groups. RESULTS: The patient sample was 85.9% (13,333) white and 52.5% (7375) male. On average, patients were 62.8 (SD, 11.7) years old and with obesity (mean BMI: 34.2 ± 7.2 kg/m2) with uncontrolled T2DM (initial HbA1c: 8.5 ± 1.5%). After PSM, portal users (n = 4924) and non-users (n = 4924) were matched on all variables except for the insurance. The mixed-effects modeling showed a nonlinear decrease of HbA1c in both groups over time. A significant interaction was observed with a greater decline, followed by a smaller rise of HbA1c in portal users than non-users. CONCLUSIONS: The use of the patient portal was significantly associated with a lower HbA1c. This finding supports patient portals as a promising tool for improving clinical outcomes in patients with uncontrolled T2DM.
Authors: Ana Luisa Neves; Katelyn R Smalley; Lisa Freise; Paul Harrison; Ara Darzi; Erik K Mayer Journal: J Med Internet Res Date: 2021-11-11 Impact factor: 5.428