Amante Daniel J, Hogan Timothy P, Pagoto Sherry L, English Thomas M
1 Clinical & Population Health Research Doctoral Program, Graduate School of Biomedical Sciences, University of Massachusetts Medical School , Worcester, Massachusetts.
Diabetes Technol Ther. 2014 Nov;16(11):784-93. doi: 10.1089/dia.2014.0078. Epub 2014 Jul 7.
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.
（1）研究糖尿病患者中与门户网站注册及使用相关的特征；（2）确定电子患者门户网站注册及使用的障碍和促进因素。我们系统检索了PubMed和护理及联合健康文献累积索引（CINAHL），以查找使用定量或定性方法报告有关美国糖尿病患者门户网站注册及使用的特征、障碍和促进因素的原创研究的论文。检索限于2005年2月1日（个人健康记录全国研讨会日期）至2014年1月1日期间发表的文章。共识别出16篇文章。其中，9篇为定量研究，3篇为定性研究，4篇采用混合方法。一些人口统计学特征、糖尿病控制较好以及参与并鼓励使用门户网站的医疗服务提供者与门户网站注册及使用的增加有关。门户网站注册的障碍包括患者缺乏（1）能力、（2）意愿以及（3）对门户网站/门户网站功能的认知。门户网站使用的障碍包括（1）患者能力、（2）医疗服务提供者和患者对门户网站益处缺乏认同，以及（3）患者使用门户网站的负面体验。门户网站注册及使用的促进因素是医疗服务提供者和家庭成员推荐并参与门户网站的使用。改善可用性、增加访问机会、教育患者如何使用门户网站并从中受益，以及医疗服务提供者和家庭成员更多的认可可能会增加门户网站的注册及使用。随着越来越多的医疗服务提供者和医院提供门户网站，解决障碍并利用促进因素可能有助于糖尿病患者获得潜在益处。
