Patient access to portal self-management tools through mobile devices may help significantly improve diabetes care, according to a new study.
Patient portals work to enhance communication with the health care team and offer a convenient means to viewing laboratory test results and ordering prescription refills. In chronic conditions such as diabetes, ongoing disease self-management is crucial for optimal patient outcomes, and technology can help further support this.
The study, which was published in JAMA Network Open, evaluated whether the addition of mobile portal access is associated with adherence to oral diabetes medications and glycemic levels for patients with diabetes.
The cohort included 111,463 patients with diabetes treated at Kaiser Permanente Northern California from April 1, 2015 to December 31, 2017. All patients in the study had an oral diabetes prescription at baseline with no insulin use.
Notably, the researchers noted that patients with higher clinical need at baseline experienced greater improvements with added mobile portal access. However, even among patients with lower baseline glycemic levels, statistically significant improvements were still observed over time.
Among the patients with no prior portal access, adding computer-only portal access was associated with an increase in monthly percentage of days covered (PDC), a measure of medication adherence, of 1.16 (95% CI, 0.63 to 1.70) percentage points and a change of -0.06 (95% CI, -0.08 to -0.03) percentage points in HbA1c level.
The results also showed that adding both mobile and computer portal access was linked to an increase in PDC of 1.67 (95% CI, 1.10 to 2.23) percentage points and a change of -0.013 (95% CI, -0.16 to -0.10) percentage points and a change of -0.13 (95% CI, -0.16 to 0.10) percentage points in HbA1c level.
In patients with higher baseline HbA1c level, changing from no portal access to both computer and mobile access led to an increase in PDC of 5.09 (95% CI, 3.78 to 6.40) percentage points and a change of -0.19 O95% CI, -0.27 to 0.15) percentage points in HbA1c level.
According to the researchers, “adding mobile portal access may be an important gateway for reaching and improving care for patients with the highest clinical need, limited health care engagement, or other barriers to care.”
The findings suggest that designing portal programs to include accessibility from mobile devices could help reach patients with diabetes who are at higher risk of nonadherence and poor outcomes.
1. Graetz I, Huang J, Muelly ER, et al. Association of mobile patient portal access with diabetes medication adherence and glycemic levels among adults with diabetes. JAMA Network Open. 2020. Doi: 10.1001/jamanetworkopen.2019.21429