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. 2020 Sep 22;22(9):e18976.
doi: 10.2196/18976.

Patient Portal Functionalities and Patient Outcomes Among Patients With Diabetes: Systematic Review

Abrar Alturkistani  1 , Ambar Qavi  2 , Philip Emeka Anyanwu  1 , Geva Greenfield  3 , Felix Greaves  1 , Ceire Costelloe  1
Affiliations

Patient Portal Functionalities and Patient Outcomes Among Patients With Diabetes: Systematic Review

Abrar Alturkistani et al. J Med Internet Res. .

Abstract

Background: Patient portal use could help improve the care and health outcomes of patients with diabetes owing to functionalities, such as appointment booking, electronic messaging (e-messaging), and repeat prescription ordering, which enable patient-centered care and improve patient self-management of the disease.

Objective: This review aimed to summarize the evidence regarding patient portal use (portals that are connected to electronic health care records) or patient portal functionality use (eg, appointment booking and e-messaging) and their reported associations with health and health care quality outcomes among adult patients with diabetes.

Methods: We searched the MEDLINE, Embase, and Scopus databases and reported the review methodology using the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. Three independent reviewers screened titles and abstracts, and two reviewers assessed the full texts of relevant studies and performed data extraction and quality assessments of the included studies. We used the Cochrane Collaboration Risk of Bias Tool and the National Heart, Lung and Blood Institute (NHLBI) Study Quality Assessment Tool to assess the risk of bias of the included studies. Data were summarized through narrative synthesis.

Results: Twelve studies were included in this review. Five studies reported overall patient portal use and its association with diabetes health and health care quality outcomes. Six studies reported e-messaging or email use-associated outcomes, and two studies reported prescription refill-associated outcomes. The reported health outcomes included the associations of patient portal use with blood pressure, low-density lipoprotein cholesterol, and BMI. Few studies reported health care utilization outcomes such as office visits, emergency department visits, and hospitalizations. A limited number of studies reported overall quality of care for patients with diabetes who used patient portals.

Conclusions: The included studies mostly reported improved glycemic control outcomes for patients with diabetes who used patient portals. However, limitations of studying the effects of patient portals exist, which do not guarantee whether the outcomes reported are completely the result of patient portal use or if confounding factors exist. Randomized controlled trials and mixed-methods studies could help understand the mechanisms involved in health outcome improvements and patient portal use among patients with diabetes.

Trial registration: International Prospective Register of Systematic Reviews (PROSPERO) CRD42019141131; https://www.crd.york.ac.uk/prospero/display_record.php?ID=CRD42019141131.

International registered report identifier (irrid): RR2-10.2196/14975.

Keywords: electronic health records; online access; patient portal; patient records; personal health record; systematic review.

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Conflict of interest statement

Conflicts of Interest: None declared.

Figures

Figure 1
Figure 1
Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) flow diagram of the search and study selection process.
See this image and copyright information in PMC

References

    1. Ancker JS, Osorio SN, Cheriff A, Cole CL, Silver M, Kaushal R. Patient activation and use of an electronic patient portal. Inform Health Soc Care. 2015;40(3):254–66. doi: 10.3109/17538157.2014.908200. - DOI - PubMed
    1. Kruse CS, Argueta DA, Lopez L, Nair A. Patient and provider attitudes toward the use of patient portals for the management of chronic disease: a systematic review. J Med Internet Res. 2015 Feb 20;17(2):e40. doi: 10.2196/jmir.3703. https://www.jmir.org/2015/2/e40/ - DOI - PMC - PubMed
    1. Otte-Trojel T, de Bont A, Rundall TG, van de Klundert J. How outcomes are achieved through patient portals: a realist review. J Am Med Inform Assoc. 2014;21(4):751–7. doi: 10.1136/amiajnl-2013-002501. http://europepmc.org/abstract/MED/24503882 - DOI - PMC - PubMed
    1. Pillemer F, Price RA, Paone S, Martich GD, Albert S, Haidari L, Updike G, Rudin R, Liu D, Mehrotra A. Direct Release of Test Results to Patients Increases Patient Engagement and Utilization of Care. PLoS One. 2016;11(6):e0154743. doi: 10.1371/journal.pone.0154743. https://dx.plos.org/10.1371/journal.pone.0154743 - DOI - DOI - PMC - PubMed
    1. Robinson SA, Zocchi MS, Netherton D, Ash A, Purington CM, Connolly SL, Vimalananda VG, Hogan TP, Shimada SL. Secure Messaging, Diabetes Self-management, and the Importance of Patient Autonomy: a Mixed Methods Study. J Gen Intern Med. 2020 May 21; doi: 10.1007/s11606-020-05834-x. - DOI - PMC - PubMed

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