According to a new study, patient access to portal self-management tools via mobile devices can be significantly helpful to improve diabetes care. Not only patient portals work to enhance communication with the health care team, they also offer a convenient means to viewing laboratory test results and ordering prescription refills. In chronic conditions such as diabetes, ongoing disease self-management is critical for optimal patient outcomes. Hence, technology can help further support this.
Published in JAMA Network Open, a study evaluated whether the addition of mobile portal access was 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 1 April 2015 to 31 December 2017. All patients in the study had an oral diabetes prescription at baseline with no insulin use.
The researchers noted that patients with higher clinical need at baseline experienced greater improvements, along with added mobile portal 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, the addition of computer-only portal access increased 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% confidence interval (CI), -0.08 to -0.03) percentage points in HbA1c level.
The results also showed that adding both mobile and computer portal access resulted into 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, change from no portal access to both computer as well as mobile access led to an increase in PDC of 5.09 (95% CI, 3.78 to 6.40) percentage points, along with a change of -0.19 O95% CI, -0.27 to 0.15) percentage points in HbA1c level.
The researchers said:
“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 suggested that designing portal programs to include accessibility from mobile devices could help to reach diabetes patients with higher risk of nonadherence and poor outcome.