Improving Diabetes Care Through Effective Personalized Patient Portal Interactions

VA Office of Research and Development

Status: Completed

Conditions: Diabetes Mellitus

Treatments: Behavioral: My HealtheVet Individual Training; Behavioral: My HealtheVet Brochure; Behavioral: My HealtheVet Training Guide for Veterans Living with Diabetes; Behavioral: My HealtheVet Group Training

Study type: Interventional

Funder types: Other U.S. Federal agency

Identifiers

NCT02953262

IIR 15-307

Details and patient eligibility

About

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.

Full description

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.

Enrollment: 275 patients

Sex: All

Ages: 18 to 85 years old

Volunteers: No Healthy Volunteers

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

Trial design

Primary purpose: Health Services Research

Allocation: Randomized

Interventional model: Parallel Assignment

Masking: Single Blind

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275 participants in 4 patient groups

Encouragement Arm 1

Experimental group

Description:

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.

Treatment:

Behavioral: My HealtheVet Group Training

Behavioral: My HealtheVet Individual Training

Behavioral: My HealtheVet Training Guide for Veterans Living with Diabetes

Behavioral: My HealtheVet Brochure

Encouragement Arm 2

Experimental group

Description:

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.

Treatment:

Behavioral: My HealtheVet Group Training

Behavioral: My HealtheVet Training Guide for Veterans Living with Diabetes

Behavioral: My HealtheVet Brochure

Encouragement Arm 3

Experimental group

Description:

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.

Treatment:

Behavioral: My HealtheVet Group Training

Behavioral: My HealtheVet Training Guide for Veterans Living with Diabetes

Brochure Only Comparison Arm

Other group

Description:

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.)

Treatment:

Behavioral: My HealtheVet Group Training