Trial Outcomes & Findings for Improving Diabetes Care Through Effective Personalized Patient Portal Interactions (NCT NCT02953262)
NCT ID: NCT02953262
Last Updated: 2023-07-28
Results Overview
This measure captures any use of MHV within 180 days of the brochure mailing, including use of prescription refills, secure messaging, Blue Button, or any other portal features.
Recruitment status
COMPLETED
Study phase
NA
Target enrollment
275 participants
Primary outcome timeframe
Portal use within 180 days of initial brochure mailing
Results posted on
2023-07-28
Participant Flow
Patients meeting eligibility criteria were identified from clinical records and mailed an invitation to participate in the study along with a My HealtheVet brochure and an information sheet describing the study. Initial invitations were sent out in June 2019 at Site 1 and in December 2019 at Site 2. Patients who did not opt out were enrolled and randomized into study arms in July 2019 and January 2020, respectively.
One patient was mistakenly randomized to an arm even though he was deceased shortly prior to enrollment because he met the eligibility criteria according to our databases, including having a future appointment scheduled. Fifteen patients from one site were incorrectly identified as not having used the portal in the 12 months prior to the trial and were excluded from the analyses.
Participant milestones
| Measure |
Brochure Only Comparison Arm
The comparison condition only received a mailed brochure with basic My HealtheVet content during the trial.
After the completion of their interview, they were offered a copy of the training guide.
|
Encouragement Arm 1
Participants in this encouragement condition received a brochure about the My HealtheVet portal and were mailed 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.
|
Encouragement Arm 2
Participants in this encouragement condition received the My HealtheVet brochure and training guide, but was also offered optional attendance at one of several group training sessions.
|
Encouragement Arm 3
Participants in this encouragement condition received the same encouragement as in Arm 2 (brochure, training guide and group training offer) but were also offered a one-on-one My HealtheVet training session.
|
|---|---|---|---|---|
|
Overall Study
STARTED
|
68
|
69
|
68
|
70
|
|
Overall Study
COMPLETED
|
65
|
63
|
65
|
67
|
|
Overall Study
NOT COMPLETED
|
3
|
6
|
3
|
3
|
Reasons for withdrawal
| Measure |
Brochure Only Comparison Arm
The comparison condition only received a mailed brochure with basic My HealtheVet content during the trial.
After the completion of their interview, they were offered a copy of the training guide.
|
Encouragement Arm 1
Participants in this encouragement condition received a brochure about the My HealtheVet portal and were mailed 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.
|
Encouragement Arm 2
Participants in this encouragement condition received the My HealtheVet brochure and training guide, but was also offered optional attendance at one of several group training sessions.
|
Encouragement Arm 3
Participants in this encouragement condition received the same encouragement as in Arm 2 (brochure, training guide and group training offer) but were also offered a one-on-one My HealtheVet training session.
|
|---|---|---|---|---|
|
Overall Study
Used portal during 6 months prior to randomization
|
3
|
6
|
3
|
3
|
Baseline Characteristics
Improving Diabetes Care Through Effective Personalized Patient Portal Interactions
Baseline characteristics by cohort
| Measure |
Brochure Only Comparison Arm
n=65 Participants
The comparison condition only received a mailed brochure with basic My HealtheVet content during the trial.
After the completion of their telephone interview, they were offered a copy of the training guide.
|
Encouragement Arm 1
n=63 Participants
Participants in this encouragement condition received a brochure about the My HealtheVet portal and were also mailed 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.
|
Encouragement Arm 2
n=65 Participants
Participants in this encouragement condition received the My HealtheVet brochure and training guide, but were also offered optional attendance at one of several group training sessions.
|
Encouragement Arm 3
n=67 Participants
Participants in this encouragement condition received the same encouragement as in Arm 2 (brochure, training guide and group training offer) but were also offered a one-on-one My HealtheVet training session.
|
Total
n=260 Participants
Total of all reporting groups
|
|---|---|---|---|---|---|
|
Age, Continuous
|
67.7 years
STANDARD_DEVIATION 10.3 • n=5 Participants
|
68.3 years
STANDARD_DEVIATION 8.8 • n=7 Participants
|
68.5 years
STANDARD_DEVIATION 8.8 • n=5 Participants
|
70.0 years
STANDARD_DEVIATION 9.1 • n=4 Participants
|
68.7 years
STANDARD_DEVIATION 9.2 • n=21 Participants
|
|
Sex: Female, Male
Female
|
2 Participants
n=5 Participants
|
1 Participants
n=7 Participants
|
2 Participants
n=5 Participants
|
0 Participants
n=4 Participants
|
5 Participants
n=21 Participants
|
|
Sex: Female, Male
Male
|
63 Participants
n=5 Participants
|
62 Participants
n=7 Participants
|
63 Participants
n=5 Participants
|
67 Participants
n=4 Participants
|
255 Participants
n=21 Participants
|
|
Race/Ethnicity, Customized
White
|
54 Participants
n=5 Participants
|
47 Participants
n=7 Participants
|
57 Participants
n=5 Participants
|
55 Participants
n=4 Participants
|
213 Participants
n=21 Participants
|
|
Race/Ethnicity, Customized
Black/African-American
|
5 Participants
n=5 Participants
|
6 Participants
n=7 Participants
|
4 Participants
n=5 Participants
|
5 Participants
n=4 Participants
|
20 Participants
n=21 Participants
|
|
Race/Ethnicity, Customized
Latino
|
4 Participants
n=5 Participants
|
5 Participants
n=7 Participants
|
4 Participants
n=5 Participants
|
0 Participants
n=4 Participants
|
13 Participants
n=21 Participants
|
|
Race/Ethnicity, Customized
Other
|
0 Participants
n=5 Participants
|
1 Participants
n=7 Participants
|
0 Participants
n=5 Participants
|
2 Participants
n=4 Participants
|
3 Participants
n=21 Participants
|
|
Race/Ethnicity, Customized
Unknown/Missing
|
2 Participants
n=5 Participants
|
4 Participants
n=7 Participants
|
0 Participants
n=5 Participants
|
5 Participants
n=4 Participants
|
11 Participants
n=21 Participants
|
|
Region of Enrollment
United States
|
65 Participants
n=5 Participants
|
63 Participants
n=7 Participants
|
65 Participants
n=5 Participants
|
67 Participants
n=4 Participants
|
260 Participants
n=21 Participants
|
|
Rural Residence
|
0 Participants
n=5 Participants
|
2 Participants
n=7 Participants
|
3 Participants
n=5 Participants
|
2 Participants
n=4 Participants
|
7 Participants
n=21 Participants
|
|
Marital Status
Married
|
30 Participants
n=5 Participants
|
30 Participants
n=7 Participants
|
31 Participants
n=5 Participants
|
34 Participants
n=4 Participants
|
125 Participants
n=21 Participants
|
|
Marital Status
Widowed
|
4 Participants
n=5 Participants
|
4 Participants
n=7 Participants
|
5 Participants
n=5 Participants
|
3 Participants
n=4 Participants
|
16 Participants
n=21 Participants
|
|
Marital Status
Divorced/Separated
|
19 Participants
n=5 Participants
|
14 Participants
n=7 Participants
|
24 Participants
n=5 Participants
|
18 Participants
n=4 Participants
|
75 Participants
n=21 Participants
|
|
Marital Status
Single
|
12 Participants
n=5 Participants
|
15 Participants
n=7 Participants
|
5 Participants
n=5 Participants
|
12 Participants
n=4 Participants
|
44 Participants
n=21 Participants
|
|
Average HbA1c at baseline (2019)
|
9.6 % (DCCT units)
STANDARD_DEVIATION 1.3 • n=5 Participants
|
9.3 % (DCCT units)
STANDARD_DEVIATION 1.0 • n=7 Participants
|
9.5 % (DCCT units)
STANDARD_DEVIATION 1.3 • n=5 Participants
|
9.3 % (DCCT units)
STANDARD_DEVIATION 1.1 • n=4 Participants
|
9.4 % (DCCT units)
STANDARD_DEVIATION 1.2 • n=21 Participants
|
PRIMARY outcome
Timeframe: Portal use within 180 days of initial brochure mailingPopulation: Patients randomized to each arm who had not used My HealtheVet in the 12 months prior to randomization. At the second site, 15 people who should have been excluded were inadvertently included in the sample because the criteria of no secure messaging use in previous 12 months was mistakenly used instead of no patient portal use in the previous 12 months. We did not discover this until after the trial was complete because there were delays in receiving actual portal use data.
This measure captures any use of MHV within 180 days of the brochure mailing, including use of prescription refills, secure messaging, Blue Button, or any other portal features.
Outcome measures
| Measure |
Brochure Only Comparison Arm
n=65 Participants
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 6-month interview.)
Brochure Only Intervention 4: Participants will receive a mailed brochure with basic My HealtheVet content.
|
Encouragement Arm 1
n=63 Participants
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.
Supported Adopted Intervention 1: Participants in this encouragement condition will receive a mailed brochure 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.
Brochure Only Intervention 4: Participants will receive a mailed brochure with basic My HealtheVet content.
|
Encouragement Arm 2
n=65 Participants
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.
Supported Adopted Intervention 1: Participants in this encouragement condition will receive a mailed brochure 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.
Supported Adopted Intervention 2: Participants will be offered optional attendance at a group training session in addition to receiving the brochure and training guide by mail. These sessions will be offered at a computer lab at the VA hospital.
Brochure Only Intervention 4: Participants will receive a mailed brochure with basic My HealtheVet content.
|
Encouragement Arm 3
n=67 Participants
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.
Supported Adopted Intervention 1: Participants in this encouragement condition will receive a mailed brochure 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.
Supported Adopted Intervention 2: Participants will be offered optional attendance at a group training session in addition to receiving the brochure and training guide by mail. These sessions will be offered at a computer lab at the VA hospital.
Supported Adopted Intervention 3: Participants will also be offered a one-on-one My HealtheVet training session in addition to the brochure, training guide, and offer of group training session.
Brochure Only Intervention 4: Participants will receive a mailed brochure with basic My HealtheVet content.
|
|---|---|---|---|---|
|
Any My HealtheVet Patient Portal Use
|
6 Participants
|
1 Participants
|
5 Participants
|
8 Participants
|
SECONDARY outcome
Timeframe: 180 days from brochure mailingAfter registering for the portal, patients must confirm their identity and accept the terms and conditions of the portal in order to upgrade to Premium status which allows access to secure messaging, their VA appointments, and electronic health record extracts such as lab results, medical imaging and reports, clinical notes, and their VA health summary. Patients can access a limited subset of portal features, including online prescription refills, without upgrading to Premium. This measure captures whether a participant upgraded to a Premium account during the trial.
Outcome measures
| Measure |
Brochure Only Comparison Arm
n=65 Participants
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 6-month interview.)
Brochure Only Intervention 4: Participants will receive a mailed brochure with basic My HealtheVet content.
|
Encouragement Arm 1
n=63 Participants
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.
Supported Adopted Intervention 1: Participants in this encouragement condition will receive a mailed brochure 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.
Brochure Only Intervention 4: Participants will receive a mailed brochure with basic My HealtheVet content.
|
Encouragement Arm 2
n=65 Participants
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.
Supported Adopted Intervention 1: Participants in this encouragement condition will receive a mailed brochure 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.
Supported Adopted Intervention 2: Participants will be offered optional attendance at a group training session in addition to receiving the brochure and training guide by mail. These sessions will be offered at a computer lab at the VA hospital.
Brochure Only Intervention 4: Participants will receive a mailed brochure with basic My HealtheVet content.
|
Encouragement Arm 3
n=67 Participants
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.
Supported Adopted Intervention 1: Participants in this encouragement condition will receive a mailed brochure 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.
Supported Adopted Intervention 2: Participants will be offered optional attendance at a group training session in addition to receiving the brochure and training guide by mail. These sessions will be offered at a computer lab at the VA hospital.
Supported Adopted Intervention 3: Participants will also be offered a one-on-one My HealtheVet training session in addition to the brochure, training guide, and offer of group training session.
Brochure Only Intervention 4: Participants will receive a mailed brochure with basic My HealtheVet content.
|
|---|---|---|---|---|
|
Patient Upgraded to a Premium My HealtheVet Portal Account
|
0 Participants
|
1 Participants
|
2 Participants
|
5 Participants
|
SECONDARY outcome
Timeframe: 180 days from brochure mailingThis measure captures whether the participant used the portal's online prescription refill feature at least once within 180 days of mailing the brochure.
Outcome measures
| Measure |
Brochure Only Comparison Arm
n=65 Participants
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 6-month interview.)
Brochure Only Intervention 4: Participants will receive a mailed brochure with basic My HealtheVet content.
|
Encouragement Arm 1
n=63 Participants
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.
Supported Adopted Intervention 1: Participants in this encouragement condition will receive a mailed brochure 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.
Brochure Only Intervention 4: Participants will receive a mailed brochure with basic My HealtheVet content.
|
Encouragement Arm 2
n=65 Participants
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.
Supported Adopted Intervention 1: Participants in this encouragement condition will receive a mailed brochure 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.
Supported Adopted Intervention 2: Participants will be offered optional attendance at a group training session in addition to receiving the brochure and training guide by mail. These sessions will be offered at a computer lab at the VA hospital.
Brochure Only Intervention 4: Participants will receive a mailed brochure with basic My HealtheVet content.
|
Encouragement Arm 3
n=67 Participants
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.
Supported Adopted Intervention 1: Participants in this encouragement condition will receive a mailed brochure 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.
Supported Adopted Intervention 2: Participants will be offered optional attendance at a group training session in addition to receiving the brochure and training guide by mail. These sessions will be offered at a computer lab at the VA hospital.
Supported Adopted Intervention 3: Participants will also be offered a one-on-one My HealtheVet training session in addition to the brochure, training guide, and offer of group training session.
Brochure Only Intervention 4: Participants will receive a mailed brochure with basic My HealtheVet content.
|
|---|---|---|---|---|
|
Use of Online Prescription Refills
|
5 Participants
|
1 Participants
|
0 Participants
|
3 Participants
|
SECONDARY outcome
Timeframe: 180 days from brochure mailingPatient used the secure messaging feature during the trial
Outcome measures
| Measure |
Brochure Only Comparison Arm
n=65 Participants
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 6-month interview.)
Brochure Only Intervention 4: Participants will receive a mailed brochure with basic My HealtheVet content.
|
Encouragement Arm 1
n=63 Participants
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.
Supported Adopted Intervention 1: Participants in this encouragement condition will receive a mailed brochure 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.
Brochure Only Intervention 4: Participants will receive a mailed brochure with basic My HealtheVet content.
|
Encouragement Arm 2
n=65 Participants
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.
Supported Adopted Intervention 1: Participants in this encouragement condition will receive a mailed brochure 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.
Supported Adopted Intervention 2: Participants will be offered optional attendance at a group training session in addition to receiving the brochure and training guide by mail. These sessions will be offered at a computer lab at the VA hospital.
Brochure Only Intervention 4: Participants will receive a mailed brochure with basic My HealtheVet content.
|
Encouragement Arm 3
n=67 Participants
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.
Supported Adopted Intervention 1: Participants in this encouragement condition will receive a mailed brochure 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.
Supported Adopted Intervention 2: Participants will be offered optional attendance at a group training session in addition to receiving the brochure and training guide by mail. These sessions will be offered at a computer lab at the VA hospital.
Supported Adopted Intervention 3: Participants will also be offered a one-on-one My HealtheVet training session in addition to the brochure, training guide, and offer of group training session.
Brochure Only Intervention 4: Participants will receive a mailed brochure with basic My HealtheVet content.
|
|---|---|---|---|---|
|
Use of Secure Messaging
|
1 Participants
|
1 Participants
|
2 Participants
|
7 Participants
|
Adverse Events
Comparison Arm
Serious events: 0 serious events
Other events: 0 other events
Deaths: 1 deaths
Encouragement Arm 1
Serious events: 0 serious events
Other events: 0 other events
Deaths: 0 deaths
Encouragement Arm 2
Serious events: 0 serious events
Other events: 0 other events
Deaths: 4 deaths
Encouragement Arm 3
Serious events: 0 serious events
Other events: 0 other events
Deaths: 0 deaths
Serious adverse events
Adverse event data not reported
Other adverse events
Adverse event data not reported
Additional Information
Stephanie Shimada, PhD
Center for Healthcare Organization and Implementation Research (CHOIR) United States Department of Veterans Affairs VA Bedford Healthcare System
Phone: 781-687-2208
Email: [email protected]
Results disclosure agreements
- Principal investigator is a sponsor employee
- Publication restrictions are in place