Improving Diabetes Care Through Effective Personalized Patient Portal Interactions

NCT ID: NCT02953262

Last Updated: 2023-07-28

Study Results

Results available

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Basic Information

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Recruitment Status

COMPLETED

Clinical Phase

NA

Total Enrollment

275 participants

Study Classification

INTERVENTIONAL

Study Start Date

2019-07-22

Study Completion Date

2020-09-30

Brief Summary

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Patient-facing eHealth technologies, such as online patient portals, connect patients with the healthcare system, help them access their health information, and support self-management of health conditions. This study tested an intervention to improve adoption and use of the My HealtheVet patient portal for diabetes management.

Detailed Description

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The goal of this small scale study is to test the feasibility of engaging Veterans in a supported adoption intervention to promote effective patient portal use in a sample of Veterans with uncontrolled Type II diabetes.

Participants were eligible for recruitment if they were Veterans age 18-85 who were actively receiving care at one of the study sites (as determined by having an upcoming scheduled appointment), had uncontrolled glucose (HbA1c \>= 8.5%), and had either never used the VA patient portal or were inactive registrants who have not used the patient portal in the past 12 months. Participants who met these conditions and did not opt out of the study were randomized to one of four arms: 1) Encouragement I (brochure + mailed training guide), 2) Encouragement II (brochure + mailed training guide + invitation to group training), 3) Encouragement III (brochure + mailed training guide + invitation to group and one-on-one training), and 4) Comparison (standard patient portal enrollment brochure only). All arms received the standard My HealtheVet patient portal enrollment brochure along with an invitation to participate in the study. Those randomized to any of the Encouragement Arms received a mailed training guide. The My HealtheVet Training Guide for Veterans Living with Diabetes was designed in conjunction with Veteran co-investigators based on feedback from patients living with diabetes who were My HealtheVet users. It provided step by step guidance on how to use the features Veterans living with diabetes find most helpful with specific examples of use for diabetes self-management. Those in Encouragement Arm II were also invited to attend one of several group training sessions. Those in Encouragement III were invited to schedule a one-on one session to learn how to use the patient portal. Those in the comparison condition were asked during their interview if they would like a Training Guide mailed to them at the end of the trial, and those interested were mailed a Training Guide.

Conditions

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Diabetes Mellitus

Study Design

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Allocation Method

RANDOMIZED

Intervention Model

PARALLEL

Primary Study Purpose

HEALTH_SERVICES_RESEARCH

Blinding Strategy

SINGLE

Participants
Participants were not explicitly told which group they were randomized to

Study Groups

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Encouragement Arm 1

Participants in this encouragement condition will receive a mailed brochure with basic My HealtheVet content and a training guide with (a) insights from other Veterans on how to use My HealtheVet for diabetes self-management, (b) step-by-step guidance for how to sign up for My HealtheVet and, (c) detailed guidance on how to learn to use key features.

Group Type EXPERIMENTAL

My HealtheVet Brochure

Intervention Type BEHAVIORAL

Participants will receive a mailed brochure with basic My HealtheVet content.

My HealtheVet Training Guide for Veterans Living with Diabetes

Intervention Type BEHAVIORAL

Participants will be mailed a bound My HealtheVet training guide with step by step instructions on how to register, upgrade to Premium account, refill prescriptions, use secure messaging, download their Blue Button reports, and other features

My HealtheVet Group Training

Intervention Type BEHAVIORAL

Participants will be invited to participate in a scheduled group training to learn how to use My HealtheVet to help manage their diabetes

My HealtheVet Individual Training

Intervention Type BEHAVIORAL

Participants will be invited to participate in a one-on-one training to learn how to use My HealtheVet to help manage their diabetes at a time of their convenience.

Encouragement Arm 2

Participants in this encouragement condition will receive the same brochure and training guide as Arm 1 but will also be offered optional attendance at one of several group training sessions.

Group Type EXPERIMENTAL

My HealtheVet Brochure

Intervention Type BEHAVIORAL

Participants will receive a mailed brochure with basic My HealtheVet content.

My HealtheVet Training Guide for Veterans Living with Diabetes

Intervention Type BEHAVIORAL

Participants will be mailed a bound My HealtheVet training guide with step by step instructions on how to register, upgrade to Premium account, refill prescriptions, use secure messaging, download their Blue Button reports, and other features

My HealtheVet Group Training

Intervention Type BEHAVIORAL

Participants will be invited to participate in a scheduled group training to learn how to use My HealtheVet to help manage their diabetes

Encouragement Arm 3

Participants in this encouragement condition will receive the same as in Arm 2 (brochure, training guide, and group training offer) but will also be offered a one-on-one My HealtheVet training session.

Group Type EXPERIMENTAL

My HealtheVet Training Guide for Veterans Living with Diabetes

Intervention Type BEHAVIORAL

Participants will be mailed a bound My HealtheVet training guide with step by step instructions on how to register, upgrade to Premium account, refill prescriptions, use secure messaging, download their Blue Button reports, and other features

My HealtheVet Group Training

Intervention Type BEHAVIORAL

Participants will be invited to participate in a scheduled group training to learn how to use My HealtheVet to help manage their diabetes

Brochure Only Comparison Arm

The Comparison condition will only receive a mailed brochure with basic My HealtheVet content during the trial. (The training guide will be mailed to them after completion of the interview at the end.)

Group Type OTHER

My HealtheVet Group Training

Intervention Type BEHAVIORAL

Participants will be invited to participate in a scheduled group training to learn how to use My HealtheVet to help manage their diabetes

Interventions

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My HealtheVet Brochure

Participants will receive a mailed brochure with basic My HealtheVet content.

Intervention Type BEHAVIORAL

My HealtheVet Training Guide for Veterans Living with Diabetes

Participants will be mailed a bound My HealtheVet training guide with step by step instructions on how to register, upgrade to Premium account, refill prescriptions, use secure messaging, download their Blue Button reports, and other features

Intervention Type BEHAVIORAL

My HealtheVet Group Training

Participants will be invited to participate in a scheduled group training to learn how to use My HealtheVet to help manage their diabetes

Intervention Type BEHAVIORAL

My HealtheVet Individual Training

Participants will be invited to participate in a one-on-one training to learn how to use My HealtheVet to help manage their diabetes at a time of their convenience.

Intervention Type BEHAVIORAL

Eligibility Criteria

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Inclusion Criteria

* Veterans
* Hemoglobin A1c result \>=8.5% at most recent lab test prior to recruitment
* Non use of the VA patient portal, defined by not being registered or registered with no activity in 12 months
* Currently being seen at one of the sites participating in the study (upcoming appointment scheduled)

Exclusion Criteria

* Non-Veterans
* Controlled hemoglobin A1c levels (A1c\<8.5%) at most recent lab test prior to recruitment
* Recent use of the patient portal
Minimum Eligible Age

18 Years

Maximum Eligible Age

85 Years

Eligible Sex

ALL

Accepts Healthy Volunteers

No

Sponsors

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VA Office of Research and Development

FED

Sponsor Role lead

Responsible Party

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Responsibility Role SPONSOR

Principal Investigators

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Stephanie L Shimada, PhD

Role: PRINCIPAL_INVESTIGATOR

VA Bedford HealthCare System, Bedford, MA

Locations

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VA Bedford HealthCare System, Bedford, MA

Bedford, Massachusetts, United States

Site Status

VA Boston Healthcare System Jamaica Plain Campus, Jamaica Plain, MA

Boston, Massachusetts, United States

Site Status

Countries

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United States

References

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Robinson SA, Zocchi MS, Netherton D, Ash A, Purington CM, Connolly SL, Vimalananda VG, Hogan TP, Shimada SL. Secure Messaging, Diabetes Self-management, and the Importance of Patient Autonomy: a Mixed Methods Study. J Gen Intern Med. 2020 Oct;35(10):2955-2962. doi: 10.1007/s11606-020-05834-x. Epub 2020 May 21.

Reference Type RESULT
PMID: 32440998 (View on PubMed)

Stewart MT, Hogan TP, Nicklas J, Robinson SA, Purington CM, Miller CJ, Vimalananda VG, Connolly SL, Wolfe HL, Nazi KM, Netherton D, Shimada SL. The Promise of Patient Portals for Individuals Living With Chronic Illness: Qualitative Study Identifying Pathways of Patient Engagement. J Med Internet Res. 2020 Jul 17;22(7):e17744. doi: 10.2196/17744.

Reference Type RESULT
PMID: 32706679 (View on PubMed)

Zocchi MS, Robinson SA, Ash AS, Vimalananda VG, Wolfe HL, Hogan TP, Connolly SL, Stewart MT, Am L, Netherton D, Shimada SL. Patient portal engagement and diabetes management among new portal users in the Veterans Health Administration. J Am Med Inform Assoc. 2021 Sep 18;28(10):2176-2183. doi: 10.1093/jamia/ocab115.

Reference Type RESULT
PMID: 34339500 (View on PubMed)

Robinson SA, Netherton D, Zocchi M, Purington C, Ash AS, Shimada SL. Differences in Secure Messaging, Self-management, and Glycemic Control Between Rural and Urban Patients: Secondary Data Analysis. JMIR Diabetes. 2021 Nov 19;6(4):e32320. doi: 10.2196/32320.

Reference Type RESULT
PMID: 34807834 (View on PubMed)

Provided Documents

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Document Type: Study Protocol and Statistical Analysis Plan

View Document

Other Identifiers

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IIR 15-307

Identifier Type: -

Identifier Source: org_study_id

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