PMID- 33038473
OWN - NLM
STAT- MEDLINE
DCOM- 20210111
LR  - 20221207
IS  - 1872-8227 (Electronic)
IS  - 0168-8227 (Linking)
VI  - 170
DP  - 2020 Dec
TI  - A longitudinal examination of patient portal use on glycemic control among 
      patients with uncontrolled type 2 diabetes.
PG  - 108483
LID - S0168-8227(20)30736-1 [pii]
LID - 10.1016/j.diabres.2020.108483 [doi]
AB  - 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.
CI  - Copyright (c) 2020 Elsevier B.V. All rights reserved.
FAU - Sun, Ran
AU  - Sun R
AD  - Department of Health & Community Systems, University of Pittsburgh School of 
      Nursing, 3500 Victoria St, Pittsburgh, PA 15213, USA. Electronic address: 
      ras186@pitt.edu.
FAU - Burke, Lora E
AU  - Burke LE
AD  - Department of Health & Community Systems, University of Pittsburgh School of 
      Nursing, 3500 Victoria St, Pittsburgh, PA 15213, USA.
FAU - Korytkowski, Mary T
AU  - Korytkowski MT
AD  - Department of Medicine, University of Pittsburgh School of Medicine, 3550 Terrace 
      St, Pittsburgh, PA 15213, USA.
FAU - Saul, Melissa I
AU  - Saul MI
AD  - University of Pittsburgh School of Health and Rehabilitation Sciences, 3600 
      Atwood St, Pittsburgh, PA 15260, USA.
FAU - Li, Dan
AU  - Li D
AD  - Department of Health & Community Systems, University of Pittsburgh School of 
      Nursing, 3500 Victoria St, Pittsburgh, PA 15213, USA.
FAU - Sereika, Susan M
AU  - Sereika SM
AD  - Department of Health & Community Systems, University of Pittsburgh School of 
      Nursing, 3500 Victoria St, Pittsburgh, PA 15213, USA.
LA  - eng
PT  - Journal Article
DEP - 20201007
PL  - Ireland
TA  - Diabetes Res Clin Pract
JT  - Diabetes research and clinical practice
JID - 8508335
RN  - 0 (Glycated Hemoglobin A)
SB  - IM
MH  - Aged
MH  - Diabetes Mellitus, Type 2/*therapy
MH  - Electronic Health Records
MH  - Female
MH  - Glycated Hemoglobin/analysis
MH  - Glycemic Control/*methods
MH  - Humans
MH  - Longitudinal Studies
MH  - Male
MH  - Middle Aged
MH  - Models, Statistical
MH  - Obesity/epidemiology
MH  - Patient Portals/*statistics & numerical data
MH  - Retrospective Studies
MH  - Socioeconomic Factors
OTO - NOTNLM
OT  - Diabetes mellitus
OT  - HbA1c
OT  - Patient portals
OT  - Personal health records
OT  - Self-care
OT  - Type 2
COIS- Declaration of Competing Interest The authors declare that they do not have a 
      conflict of interest.
EDAT- 2020/10/11 06:00
MHDA- 2021/01/12 06:00
CRDT- 2020/10/10 20:09
PHST- 2020/03/09 00:00 [received]
PHST- 2020/08/23 00:00 [revised]
PHST- 2020/09/25 00:00 [accepted]
PHST- 2020/10/11 06:00 [pubmed]
PHST- 2021/01/12 06:00 [medline]
PHST- 2020/10/10 20:09 [entrez]
AID - S0168-8227(20)30736-1 [pii]
AID - 10.1016/j.diabres.2020.108483 [doi]
PST - ppublish
SO  - Diabetes Res Clin Pract. 2020 Dec;170:108483. doi: 10.1016/j.diabres.2020.108483. 
      Epub 2020 Oct 7.