Impact of patient use of an online patient portal on diabetes outcomes

Abstract

Objective: To assess the effect of patient use of an online patient portal on diabetes outcomes.

Methods: Patients included were those with diabetes who were newly referred to a Vancouver-based tertiary care diabetologist between April 2008 and October 2012. Each patient was assessed by the diabetologist, received initial diabetes education and was referred, as necessary, for further education and self-management training. All patients who provided an e-mail address at registration were invited to open an online patient portal account. The portal provided access to diabetes education material, personal laboratory values and a messaging system allowing communication with the diabetologist and staff. Patients who logged in 1 or more times were defined as portal users (n=50); patients who never logged in to the portal were defined as non-users (n=107). A1C was measured at 2 time points: at baseline (i.e. initial, in-clinic visit) and at last follow up (visit no less than 6 months and no more than 2 years after the initial visit). Because usership is self-selected, propensity score matching was used to create comparable user/non-user groups based on available baseline covariates.

Results: Compared to non-users, a higher proportion of users achieved A1C ≤7% at follow up (56% vs. 32%) (p=0.031).

Conclusion: Accessing an online patient portal is associated with improved glycemic control.

Keywords: A1C; A1c; Internet; chronic disease; diabetes mellitus; diabète sucré; maladie chronique; patient portal; portail destiné aux patients; prise en charge autonome; self-management; soins sur le Web; web-based care.