Patient Portal Use by Adults With Heart Failure

Kallmerten, Pamela S.; Chia, Lichun Rebecca; Jakub, Karen; Turk, Melanie T.

doi:10.1097/cin.0000000000000733

Cited by 3 publications

(4 citation statements)

References 21 publications

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“…In patients with HF, there are three RCTs with more than 100 patients in which the effects of digitally exchanging e‐learning and other digital information are measured 29–32 . In an RCT by Ross et al .…”

Section: Discussionmentioning

confidence: 99%

“…In patients with HF, there are three RCTs with more than 100 patients in which the effects of digitally exchanging e‐learning and other digital information are measured. 29 , 30 , 31 , 32 In an RCT by Ross et al . on 117 patients with HF, the effect of a platform containing access to electronic medical records, information about the disease of the patient, and a messaging system for communicating with the nursing staff is tested.…”

Section: Discussionmentioning

confidence: 99%

“…In patients with HF, there are three RCTs with more than 100 patients in which the effects of digitally exchanging e-learning and other digital information are measured. [29][30][31][32] In an RCT by Ross et al on 117 patients with HF, the effect of a platform containing access to electronic medical records, information about the disease of the patient, and a messaging system for communicating with the nursing staff is tested. 29 Self-efficacy, health status, patient satisfaction with doctor-patient communication, adherence to medications, and adherence to the medical regiment were assessed using questionnaires.…”

Section: Efficacy Of Digital Consults E-learning and Exchange Of Digi...mentioning

confidence: 99%

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Digital consults to optimize guideline‐directed therapy: design of a pragmatic multicenter randomized controlled trial

Man,

Dijkgraaf,

Handoko

et al. 2023

ESC Heart Failure

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AimsMany heart failure (HF) patients do not receive optimal guideline‐directed medical therapy (GDMT) despite clear benefit on morbidity and mortality outcomes. Digital consults (DCs) have the potential to improve efficiency on GDMT optimization to serve the growing HF population. The investigator‐initiated ADMINISTER trial was designed as a pragmatic multicenter randomized controlled open‐label trial to evaluate efficacy and safety of DC in patients on HF treatment.Methods and resultsPatients (n = 150) diagnosed with HF with a reduced ejection fraction will be randomized to DC or standard care (1:1). The intervention group receives multifaceted DCs including (i) digital data sharing (e.g. exchange of pharmacotherapy use and home‐measured vital signs), (ii) patient education via an e‐learning, and (iii) digital guideline recommendations to treating clinicians. The consults are performed remotely unless there is an indication to perform the consult physically. The primary outcome is the GDMT prescription rate score, and secondary outcomes include time till full GDMT optimization, patient and clinician satisfaction, time spent on healthcare, and Kansas City Cardiomyopathy Questionnaire. Results will be reported in accordance to the CONSORT statement.ConclusionsThe ADMINISTER trial will offer the first randomized controlled data on GDMT prescription rates, time till full GDMT optimization, time spent on healthcare, quality of life, and patient and clinician satisfaction of the multifaceted patient‐ and clinician‐targeted DC for GDMT optimization.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Efficacy Of Digital Consults E-learning and Exchange Of Digi...mentioning

confidence: 99%

See 1 more Smart Citation

Digital consults to optimize guideline‐directed therapy: design of a pragmatic multicenter randomized controlled trial

Man,

Dijkgraaf,

Handoko

et al. 2023

ESC Heart Failure

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“…Digital health technology has enabled patient-clinician communication to move beyond the confines of a face-to-face clinician-patient encounter. For years, the patient portal has been the primary route of electronic patient communication with providers [ 1 - 5 ]. Increasingly, there are mobile health apps that also enable communication between patients and providers through SMS, particularly for management of chronic conditions like hypertension [ 6 , 7 ].…”

Section: Introductionmentioning

confidence: 99%

Identifying Medication-Related Intents From a Bidirectional Text Messaging Platform for Hypertension Management Using an Unsupervised Learning Approach: Retrospective Observational Pilot Study

Davoudi¹,

Lee²,

Luong³

et al. 2022

J Med Internet Res

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Background Free-text communication between patients and providers plays an increasing role in chronic disease management, through platforms varying from traditional health care portals to novel mobile messaging apps. These text data are rich resources for clinical purposes, but their sheer volume render them difficult to manage. Even automated approaches, such as natural language processing, require labor-intensive manual classification for developing training data sets. Automated approaches to organizing free-text data are necessary to facilitate use of free-text communication for clinical care. Objective The aim of this study was to apply unsupervised learning approaches to (1) understand the types of topics discussed and (2) learn medication-related intents from messages sent between patients and providers through a bidirectional text messaging system for managing participant blood pressure (BP). Methods This study was a secondary analysis of deidentified messages from a remote, mobile, text-based employee hypertension management program at an academic institution. We trained a latent Dirichlet allocation (LDA) model for each message type (ie, inbound patient messages and outbound provider messages) and identified the distribution of major topics and significant topics (probability >.20) across message types. Next, we annotated all medication-related messages with a single medication intent. Then, we trained a second medication-specific LDA (medLDA) model to assess how well the unsupervised method could identify more fine-grained medication intents. We encoded each medication message with n-grams (n=1-3 words) using spaCy, clinical named entities using Stanza, and medication categories using MedEx; we then applied chi-square feature selection to learn the most informative features associated with each medication intent. Results In total, 253 participants and 5 providers engaged in the program, generating 12,131 total messages: 46.90% (n=5689) patient messages and 53.10% (n=6442) provider messages. Most patient messages corresponded to BP reporting, BP encouragement, and appointment scheduling; most provider messages corresponded to BP reporting, medication adherence, and confirmatory statements. Most patient and provider messages contained 1 topic and few contained more than 3 topics identified using LDA. In total, 534 medication messages were annotated with a single medication intent. Of these, 282 (52.8%) were patient medication messages: most referred to the medication request intent (n=134, 47.5%). Most of the 252 (47.2%) provider medication messages referred to the medication question intent (n=173, 68.7%). Although the medLDA model could identify a majority intent within each topic, it could not distinguish medication intents with low prevalence within patient or provider messages. Richer feature engineering identified informative lexical-semantic patterns associated with each medication intent class. Conclusions LDA can be an effective method for generating subgroups of messages with similar term usage and facilitating the review of topics to inform annotations. However, few training cases and shared vocabulary between intents precludes the use of LDA for fully automated, deep, medication intent classification. International Registered Report Identifier (IRRID) RR2-10.1101/2021.12.23.21268061

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Electronic Health Records and Heart Failure

Kao¹

2022

Heart Failure Clinics

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Patient Portal Use by Adults With Heart Failure

Cited by 3 publications

References 21 publications

Digital consults to optimize guideline‐directed therapy: design of a pragmatic multicenter randomized controlled trial

Digital consults to optimize guideline‐directed therapy: design of a pragmatic multicenter randomized controlled trial

Identifying Medication-Related Intents From a Bidirectional Text Messaging Platform for Hypertension Management Using an Unsupervised Learning Approach: Retrospective Observational Pilot Study

Electronic Health Records and Heart Failure

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