A longitudinal examination of patient portal use on glycemic control among patients with uncontrolled type 2 diabetes. (December 2020)

• Record Type: Journal Article
• Authors: Sun, Ran; Burke, Lora E.; Korytkowski, Mary T.; Saul, Melissa I.; Li, Dan; Sereika, Susan M.
• Is Part Of: Diabetes research and clinical practice. Volume 170(2020)
• Publication Date: 2020-12
• Subjects: Patient portals -- Personal health records -- Diabetes mellitus -- Type 2 -- Self-care -- HbA1c; Diabetes -- Periodicals; Diabetes Mellitus -- Periodicals; 616.462
• DOI: 10.1016/j.diabres.2020.108483
• Languages: English
• ISSNs: 0168-8227

Abstract

Highlights: Patient portals facilitate access to health data and communication with providers. Engaging patients in DM self-care is essential for improving clinical outcomes. Patient portals improves glycemic control in patients with uncontrolled T2D. 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/m 2 ) 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.