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In other words, the patients who needed the most management were able to reap the most significant benefit from the online portal. The reduction in HbA1C was small but could still result in substantial improvements in future health outcomes in patients with diabetes.
Overall, patients who did not use the portal and shifted to its use via computer with later mobile access as well were more faithful in adhering to the medication by 1.67 percentage points, and their HbA1C went down by 0.13 percentage points. If only computer access was added, the medication adherence went up by 1.16 percentage points.
Even for people who were already using the portal via a computer, adding mobile access is still useful in promoting better compliance with medication regimes (up by 0.50 percentage points) and lowering blood glucose levels. Implications
Researcher Mary Reed says, "This is an example of how the health care system, by offering patients access to their own information and the ability to manage their health care online, can improve their health. Offering this in a mobile-friendly way can give even more patients the ability to engage with their health care. It literally puts access to these tools in the patient's own pocket wherever they go."
The study is vital in being the first ever to look at the association between using online tools and the effect on patient compliance with medication regime as well as objective health outcomes. Since the patients were their own controls, their behavior before beginning the use of the portal and afterward was compared to find the quantum of change. This makes the outcomes more reliable.
Moreover, in the light of earlier research, the study may suggest more extensive use of mobile apps to help patients at risk who would otherwise find it much more difficult to access appropriate levels of health care. The study concludes, "Future studies should examine how mobile portal access is associated with other types of self-management practices and care-seeking behavior."
The study is one of the latest offerings from a project that has already gone on for 10 years and was originally intended to analyze how information technology in the field of health could help health care providers to consult and help each other to ensure that the patient received better care, via the use of electronic health records.
However, the next phase of the study came to focus more on how health information technology helped patients to improve their conditions. Reed sums up the shift in study orientation over time: "In an earlier study, we found that when a physician uses an electronic health record, their patients have better control of their diabetes and have their care managed so they don't end up in the emergency room as often. And we are now also finding that patients can use technology to better manage their own care, their medications, and their diabetes."
Further exploration of this area is likely, with Reed's group pushing on to study how video telemedicine can help doctors manage patients with diabetes and how patients can manage themselves using this tool. Journal reference:
Graetz I, Huang J, Muelly ER, Fireman B, Hsu J, Reed ME. Association of Mobile Patient Portal Access With Diabetes Medication Adherence and Glycemic Levels Among Adults With Diabetes. JAMA Netw Open. 2020;3(2):e1921429. doi:10.1001/jamanetworkopen.2019.21429
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