Sun Ran, Korytkowski Mary T, Sereika Susan M, Saul Melissa I, Li Dan, Burke Lora E
Department of Health & Community Systems, University of Pittsburgh School of Nursing, Pittsburgh, PA, United States.
Division of Endocrinology and Metabolism, University of Pittsburgh School of Medicine, Pittsburgh, PA, United States.
JMIR Diabetes. 2018 Nov 6;3(4):e11199. doi: 10.2196/11199.
Health information technology tools (eg, patient portals) have the potential to promote engagement, improve patient-provider communication, and enhance clinical outcomes in the management of chronic disorders such as diabetes mellitus (DM).
The aim of this study was to report the findings of a literature review of studies reporting patient portal use by individuals with type 1 or type 2 DM. We examined the association of the patient portal use with DM-related outcomes and identified opportunities for further improvement in DM management.
Electronic literature search was conducted through PubMed and PsycINFO databases. The keywords used were "patient portal*," "web portal," "personal health record," and "diabetes." Inclusion criteria included (1) published in the past 10 years, (2) used English language, (3) restricted to age ≥18 years, and (4) available in full text.
This review included 6 randomized controlled trials, 16 observational, 4 qualitative, and 4 mixed-methods studies. The results of these studies revealed that 29% to 46% of patients with DM have registered for a portal account, with 27% to 76% of these patients actually using the portal at least once during the study period. Portal use was associated with the following factors: personal traits (eg, sociodemographics, clinical characteristics, health literacy), technology (eg, functionality, usability), and provider engagement. Inconsistent findings were observed regarding the association of patient portal use with DM-related clinical and psychological outcomes.
Barriers to use of the patient portal were identified among patients and providers. Future investigations into strategies that engage both physicians and patients in use of a patient portal to improve patient outcomes are needed.
健康信息技术工具（如患者门户网站）有潜力促进患者参与，改善医患沟通，并提升糖尿病（DM）等慢性疾病管理中的临床疗效。
本研究旨在报告一项文献综述的结果，该综述涉及1型或2型糖尿病患者使用患者门户网站的相关研究。我们研究了患者门户网站使用与糖尿病相关结局之间的关联，并确定了糖尿病管理中进一步改善的机会。
通过PubMed和PsycINFO数据库进行电子文献检索。使用的关键词为“患者门户网站*”“网络门户”“个人健康记录”和“糖尿病”。纳入标准包括：（1）在过去10年内发表；（2）使用英语；（3）限于年龄≥18岁；（4）有全文。
本综述纳入了6项随机对照试验、16项观察性研究、4项定性研究和4项混合方法研究。这些研究结果显示，29%至46%的糖尿病患者注册了门户网站账户，其中27%至76%的患者在研究期间实际至少使用过一次该门户网站。门户网站的使用与以下因素相关：个人特征（如社会人口统计学、临床特征、健康素养）、技术（如功能、可用性）和医护人员参与度。关于患者门户网站使用与糖尿病相关临床和心理结局之间的关联，观察到的结果并不一致。
在患者和医护人员中发现了使用患者门户网站的障碍。未来需要对让医生和患者都参与使用患者门户网站以改善患者结局的策略进行调查。
