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

PLoS One. 2015 Jun 18;10(6):e0129403. doi: 10.1371/journal.pone.0129403. eCollection 2015.

Abstract

Objective: A diabetes patient web portal allows patients to access their personal health record and may improve diabetes outcomes; however, patients' adoption is slow. We aimed to get insight into patients' experiences with a web portal to understand how the portal is being used, how patients perceive the content of the portal and to assess whether redesign of the portal might be needed.

Materials and methods: A survey among 1500 patients with type 1 and type 2 diabetes with a login to a patient portal.

Setting: 62 primary care practices and one outpatient hospital clinic, using a combined patient portal. We compared patients who requested a login but never used it or once ('early quitters') with patients who used it at least two times ('persistent users').

Results: 632 patients (42.1%) returned the questionnaire. Their mean age was 59.7 years, 63.1% was male and 81.8% had type 2 diabetes. 413 (65.3%) people were persistent users and 34.7% early quitters. In the multivariable analysis, insulin use (OR2.07; 95%CI[1.18-3.62]), experiencing more frequently hyperglycemic episodes (OR1.30;95%CI[1.14-1.49]) and better diabetes knowledge (OR1.02, 95%CI[1.01-1.03]) do increase the odds of being a persistent user. Persistent users perceived the usefulness of the patient portal significantly more favorable. However, they also more decisively declared that the patient portal is not helpful in supporting life style changes. Early quitters felt significantly more items not applicable in their situation compared to persistent users. Both persistent users (69.8%) and early quitters (58.8%) would prefer a reminder function for scheduled visits. About 60% of both groups wanted information about medication and side-effects in their portal.

Conclusions: The diabetes patient web portal might be improved significantly by taking into account the patients' experiences and attitudes. We propose creating separate portals for patients on insulin or not.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adult
  • Aged
  • Blood Glucose Self-Monitoring
  • Diabetes Mellitus, Type 1 / blood
  • Diabetes Mellitus, Type 1 / drug therapy
  • Diabetes Mellitus, Type 1 / psychology*
  • Diabetes Mellitus, Type 2 / blood
  • Diabetes Mellitus, Type 2 / drug therapy
  • Diabetes Mellitus, Type 2 / psychology*
  • Electronic Health Records*
  • Female
  • Health Knowledge, Attitudes, Practice*
  • Health Records, Personal*
  • Humans
  • Hypoglycemic Agents / therapeutic use
  • Internet
  • Male
  • Middle Aged
  • Patient Acceptance of Health Care / psychology
  • Patient Access to Records / psychology*

Substances

  • Hypoglycemic Agents

Associated data

  • Dryad/10.5061/dryad.F4C78

Grants and funding

This study was supported by the Diabetes Fund, The Netherlands Organization for Scientific Research in Diabetes (grant 2010.13.1369). Website: http://www.diabetesfonds.nl/overzicht/voor-onderzoekers. The funders had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript.