Outcomes/Effectiveness Research

Patient Web portals improve diabetes care and outcomes

The care and outcomes for patients with diabetes can be improved by providing access to patient Web portals (PWPs), concludes a new study. PWPs are secure Web sites that give patients access to their electronic health record, medical records, explanatory health information, and their health care providers (via E-mail), according to a new systematic review. The authors reviewed 26 articles that assessed either the impact of PWPs on care quality or outcomes, or the usability of the portals, on a total of 2,436 participants.

Among the 15 studies (involving 2,165 patients) that sought to evaluate the clinical impact of PWPs was a randomized, controlled trial (with 104 participants followed for 1 year) of a PWP that delivered a diabetes self-management program. This study found that diabetes patients given access to the PWP—and who actually used the portal—had a significant decline in diabetes distress compared with patients who had access to the portal, but did not use it. Another evaluation study found that, over a 6-month period, a composite process score representing the quality of diabetes care (in terms of clinical diabetes monitoring) improved for 62 percent of patients given access to a PWP, but only 43 percent for patients in the "usual care" control group.

Another 11 studies (involving a total of 271 patients or health care providers) assessed the usability of such systems through focus groups, interviews, surveys, or "think aloud" procedures. Several of these studies highlighted the value patients and providers place on relationships, with many exploring the extent to which PWPs might hamper or augment patient-provider relationships. The usability studies also allowed PWP developers to better understand the needs of patients, and to give providers a collaborative role in developing and improving the portal. The study was funded in part by the Agency for Healthcare Research and Quality (HS18168).

More details are in "Patient Web portals to improve diabetes outcomes: A systematic review," by Chandra Y. Osborn, Ph.D., M.P.H., Lindsay Satterwhite Mayberry, M.S., Shelagh A. Mulvaney, Ph.D., and Rachel Hess, M.D., M.S., in the December 2010 Current Diabetes Reports 10(6); pp. 422-435.

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