Clinical trial NCT02953262: Improving Diabetes Care Through Effective Personalized Patient Portal Interactions
Official title: Improving Diabetes Care Through Effective Personalized Patient Portal Interactions
Study type: INTERVENTIONAL
Overall status: COMPLETED
Phase: NA
Conditions: Diabetes Mellitus
Keywords: Diabetes Mellitus
Personal Health Records
Patient Outcome Assessment
Mental Health
Lead sponsor: VA Office of Research and Development
Sponsor class: FED
First posted: 2016-11-02
Enrollment: 275
Sex: ALL
Minimum age (years): 18
Maximum age (years): 85
Standard ages: ADULT
OLDER_ADULT
Accepts healthy volunteers: no
Allocation: RANDOMIZED
Intervention model: PARALLEL
Primary purpose: HEALTH_SERVICES_RESEARCH

Brief summary: Patient-facing eHealth technologies, such as online patient portals, connect patients with the healthcare system, help them access their health information, and support self-management of health conditions. This study tested an intervention to improve adoption and use of the My HealtheVet patient portal for diabetes management.

Detailed description: The goal of this small scale study is to test the feasibility of engaging Veterans in a supported adoption intervention to promote effective patient portal use in a sample of Veterans with uncontrolled Type II diabetes.

Participants were eligible for recruitment if they were Veterans age 18-85 who were actively receiving care at one of the study sites (as determined by having an upcoming scheduled appointment), had uncontrolled glucose (HbA1c \>= 8.5%), and had either never used the VA patient portal or were inactive registrants who have not used the patient portal in the past 12 months. Participants who met these conditions and did not opt out of the study were randomized to one of four arms: 1) Encouragement I (brochure + mailed training guide), 2) Encouragement II (brochure + mailed training guide + invitation to group training), 3) Encouragement III (brochure + mailed training guide + invitation to group and one-on-one training), and 4) Comparison (standard patient portal enrollment brochure only). All arms received the standard My HealtheVet patient portal enrollment brochure along with an invitation to participate in the study. Those randomized to any of the Encouragement Arms received a mailed training guide. The My HealtheVet Training Guide for Veterans Living with Diabetes was designed in conjunction with Veteran co-investigators based on feedback from patients living with diabetes who were My HealtheVet users. It provided step by step guidance on how to use the features Veterans living with diabetes find most helpful with specific examples of use for diabetes self-management. Those in Encouragement Arm II were also invited to attend one of several group training sessions. Those in Encouragement III were invited to schedule a one-on one session to learn how to use the patient portal. Those in the comparison condition were asked during their interview if they would like a Training Guide mailed to them at the end of the trial, and those interested were mailed a Training Guide.

Eligibility criteria: Inclusion Criteria:

* Veterans
* Hemoglobin A1c result \>=8.5% at most recent lab test prior to recruitment
* Non use of the VA patient portal, defined by not being registered or registered with no activity in 12 months
* Currently being seen at one of the sites participating in the study (upcoming appointment scheduled)

Exclusion Criteria:

* Non-Veterans
* Controlled hemoglobin A1c levels (A1c\<8.5%) at most recent lab test prior to recruitment
* Recent use of the patient portal

Primary outcomes:
measure: Any My HealtheVet Patient Portal Use
timeFrame: Portal use within 180 days of initial brochure mailing
Secondary outcomes:
measure: Patient Upgraded to a Premium My HealtheVet Portal Account
timeFrame: 180 days from brochure mailing
measure: Use of Online Prescription Refills
timeFrame: 180 days from brochure mailing
measure: Use of Secure Messaging
timeFrame: 180 days from brochure mailing
Other outcomes:
Locations:
city: Bedford
country: United States
facility: VA Bedford HealthCare System, Bedford, MA
state: Massachusetts
city: Boston
country: United States
facility: VA Boston Healthcare System Jamaica Plain Campus, Jamaica Plain, MA
state: Massachusetts
Study officials:
affiliation: VA Bedford HealthCare System, Bedford, MA
name: Stephanie L Shimada, PhD
role: PRINCIPAL_INVESTIGATOR
References:
citation: 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 Oct;35(10):2955-2962. doi: 10.1007/s11606-020-05834-x. Epub 2020 May 21.
citation: Stewart MT, Hogan TP, Nicklas J, Robinson SA, Purington CM, Miller CJ, Vimalananda VG, Connolly SL, Wolfe HL, Nazi KM, Netherton D, Shimada SL. The Promise of Patient Portals for Individuals Living With Chronic Illness: Qualitative Study Identifying Pathways of Patient Engagement. J Med Internet Res. 2020 Jul 17;22(7):e17744. doi: 10.2196/17744.
citation: Zocchi MS, Robinson SA, Ash AS, Vimalananda VG, Wolfe HL, Hogan TP, Connolly SL, Stewart MT, Am L, Netherton D, Shimada SL. Patient portal engagement and diabetes management among new portal users in the Veterans Health Administration. J Am Med Inform Assoc. 2021 Sep 18;28(10):2176-2183. doi: 10.1093/jamia/ocab115.
citation: Robinson SA, Netherton D, Zocchi M, Purington C, Ash AS, Shimada SL. Differences in Secure Messaging, Self-management, and Glycemic Control Between Rural and Urban Patients: Secondary Data Analysis. JMIR Diabetes. 2021 Nov 19;6(4):e32320. doi: 10.2196/32320.