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美国患有心血管疾病或有心血管疾病风险的成年人的患者门户网站与共同决策:一项横断面研究。

Patient Portals and Shared Decision-Making in US Adults With or at Risk of Cardiovascular Diseases: A Cross-Sectional Study.

作者信息

Chen Yuling, Spaulding Erin M, Kruahong Suratsawadee, Slone Sarah, Miller Hailey, Koirala Binu, Davidson Patricia M, Commodore-Mensah Yvonne, Dennison Himmelfarb Cheryl R

机构信息

Johns Hopkins School of Nursing Baltimore MD.

Johns Hopkins School of Medicine Baltimore MD.

出版信息

J Am Heart Assoc. 2025 May 20;14(10):e039217. doi: 10.1161/JAHA.124.039217. Epub 2025 Apr 16.

Abstract

BACKGROUND

Patient portals are secure online platforms that have shown potential to facilitate shared decision-making (SDM) in cardiovascular disease risk reduction. However, the role of health care providers (HCPs) in offering patient portals within the context of SDM remains poorly understood. This study aimed to examine the relationship between patient portal access offered by HCPs and patient engagement in SDM among adults with or at risk of cardiovascular disease in the United States (US).

METHODS

This population-based cross-sectional study included a nationally representative sample of US adults from the 2022 Health Information National Trends Survey. We performed weighted multivariable logistic regression analyses to examine the association between patient portal access offered by HCPs and patient engagement in SDM.

RESULTS

The study included a representative sample of 4234 adults with or at risk of cardiovascular disease. The mean age of the participants was 48.5 years (SD, 17.1), with 50.6% female and 62.8% White. Adults who were offered access to patient portals by HCPs (adjusted odds ratio, 2.11 [95% CI, 1.34-3.32]) and encouraged to use them (adjusted odds ratio, 1.68 [95% CI, 1.15-2.45]) were more likely to engage in SDM than their counterparts, adjusting for covariates. The extent of this association varied by demographics and social determinants of health.

CONCLUSIONS

Offering access to patient portals and encouragement to use them by HCPs was associated with high SDM among US adults with or at risk of cardiovascular disease. Future research is needed to explore the possible causal relationship between patient portal use and access and patient engagement in SDM.

摘要

背景

患者门户网站是安全的在线平台,已显示出在降低心血管疾病风险方面促进共同决策(SDM)的潜力。然而,医疗保健提供者(HCPs)在共同决策背景下提供患者门户网站的作用仍知之甚少。本研究旨在探讨美国有心血管疾病或有心血管疾病风险的成年人中,HCPs提供的患者门户网站访问与患者参与共同决策之间的关系。

方法

这项基于人群的横断面研究纳入了2022年健康信息国家趋势调查中具有全国代表性的美国成年人样本。我们进行了加权多变量逻辑回归分析,以检验HCPs提供的患者门户网站访问与患者参与共同决策之间的关联。

结果

该研究纳入了4234名有心血管疾病或有心血管疾病风险的成年人的代表性样本。参与者的平均年龄为48.5岁(标准差,17.1),其中50.6%为女性,62.8%为白人。在调整协变量后,由HCPs提供患者门户网站访问权限(调整后的优势比,2.11 [95%置信区间,1.34 - 3.32])并被鼓励使用这些门户网站的成年人(调整后的优势比,1.68 [95%置信区间,1.15 - 2.45])比未获得这些条件的成年人更有可能参与共同决策。这种关联的程度因人口统计学特征和健康的社会决定因素而异。

结论

HCPs提供患者门户网站访问权限并鼓励使用这些网站,与美国有心血管疾病或有心血管疾病风险的成年人中较高的共同决策参与度相关。未来需要进行研究,以探索患者门户网站使用和访问与患者参与共同决策之间可能的因果关系。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/62e3/12184550/88ea20d53089/JAH3-14-e039217-g001.jpg

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