A Systematic Review of Electronic Portal Usage Among Patients with Diabetes

Abstract

The objectives of this review were (1) to examine characteristics associated with enrollment and utilization of portals among patients with diabetes and (2) to identify barriers and facilitators of electronic patient portal enrollment and utilization. PubMed and the Cumulative Index to Nursing and Allied Health Literature (CINAHL) were systematically searched for papers reporting original research using quantitative or qualitative methods on characteristics, barriers, and facilitators associated with portal enrollment and utilization among patients with diabetes in the United States. The search was limited to articles published between February 1, 2005 (the date of the national symposium on personal health records) and January 1, 2014. Sixteen articles were identified. Of these, nine were quantitative, three were qualitative, and four used mixed-methods. Several demographic characteristics, having better-controlled diabetes, and providers who engaged in and encouraged portal use were associated with increased portal enrollment and utilization. Barriers to portal enrollment included a lack of patient (1) capacity, (2) desire, and (3) awareness of portal/portal functions. Barriers to portal utilization included (1) patient capacity, (2) lack of provider and patient buy-in to portal benefits, and (3) negative patient experiences using portals. Facilitators of portal enrollment and utilization were providers and family members recommending and engaging in portal use. Improved usability, increased access, educating patients how to use and benefit from portals, and greater endorsement by providers and family members might increase portal enrollment and utilization. As more providers and hospitals offer portals, addressing barriers and leveraging facilitators may help patients with diabetes achieve potential benefits.

Patients’ Experiences with and Attitudes towards a Diabetes Patient Web Portal

“…Also among parents with children with a chronic disease, low level of disease severity was one of the reasons for not using the portal [28]. However, a recent systematic review on the use of electronic portal usage among patients with diabetes showed mixed outcomes in this respect [29]. We may conclude that one uniform portal is not suitable for all patients and we should consider dividing a diabetes web portal immediately after the entrance in two parts: one for patients who are injecting insulin and another for patients who do not.…”

Patient web portals, disease management, and primary prevention

“…Only studies with a randomized controlled trial or comparative observational study design (e.g., cohort study, cross-sectional survey) were included. In addition, the references of review articles were reviewed 2,3,10,11…”

“…Previous reviews on the effectiveness of web portals in improving patient outcomes omit recently published studies on topics such as disease prevention, health disparities, and community web portals and health3,10 or the focus was on studies of web portals for a single disease 11. Our aim was to review the evidence on patient web portals for disease management, disease-specific portals, and disease prevention and to examine the disparities in portal use.…”

Methods to Evaluate the Effects of Internet-Based Digital Health Interventions for Citizens: Systematic Review of Reviews (Preprint)

“…After removing duplicates and initial screening of titles and abstracts, 42 papers were retrieved for detailed evaluation. [24,25,26] which were part of another main study [6,27,28], leading to a total of 20 unique reviews [3,6,[27][28][29][30][31][32][33][34][35][36][37][38][39][40][41][42][43][44]. The overall process of review selection was …”

“…In general there was a high satisfaction and acceptance by users of patient portals [28,32,37,38,42]. Facilitators to adoption and use of patient portals were encouragement and assistance from providers and family members as well as self-engagement, while barriers included lack of skills, desire, or knowledge, technical difficulties, and lack of potential benefits [30]. Patient engagement and use of patient portals was strongly influenced by personal factors (ethnicity, education level, health literacy, health status) and health care delivery factors (provider endorsement and usability) [3].…”