Abstract

Objective

The study sought to investigate whether consistent use of the Veterans Health Administration’s My HealtheVet (MHV) online patient portal is associated with improvement in diabetes-related physiological measures among new portal users.

Materials and Methods

We conducted a retrospective cohort study of new portal users with type 2 diabetes that registered for MHV between 2012 and 2016. We used random-effect linear regression models to examine associations between months of portal use in a year (consistency) and annual means of the physiological measures (hemoglobin A1c [HbA1c], low-density lipoproteins [LDLs], and blood pressure [BP]) in the first 3 years of portal use.

Results

For patients with uncontrolled HbA1c, LDL, or BP at baseline, more months of portal use in a year was associated with greater improvement. Compared with 1 month of use, using the portal 12 months in a year was associated with annual declines in HbA1c of -0.41% (95% confidence interval [CI], -0.46% to -0.36%) and in LDL of -6.25 (95% CI, -7.15 to -5.36) mg/dL. Twelve months of portal use was associated with minimal improvements in BP: systolic BP of -1.01 (95% CI, -1.33 to -0.68) mm Hg and diastolic BP of -0.67 (95% CI, -0.85 to -0.49) mm Hg. All associations were smaller or not present for patients in control of these measures at baseline.

Conclusions

We found consistent use of the patient portal among new portal users to be associated with modest improvements in mean HbA1c and LDL for patients at increased risk at baseline. For patients with type 2 diabetes, self-management supported by online patient portals may help control HbA1c, LDL, and BP.

中文翻译：

---

退伍军人健康管理局新门户用户之间的患者门户参与和糖尿病管理

摘要

客观的

该研究旨在调查持续使用退伍军人健康管理局的 My Health e Vet (MHV) 在线患者门户是否与新门户用户中糖尿病相关生理指标的改善有关。

材料和方法

我们对 2012 年至 2016 年间注册 MHV 的 2 型糖尿病新门户网站用户进行了一项回顾性队列研究。我们使用随机效应线性回归模型来检查一年中门户网站使用月数（一致性）与年度平均值之间的关联。门静脉使用前 3 年的生理指标（血红蛋白 A1c [HbA1c]、低密度脂蛋白 [LDL] 和血压 [BP]）。

结果

对于基线时 HbA1c、LDL 或 BP 不受控制的患者，一年中使用更多个月的门静脉与更大的改善相关。与使用 1 个月相比，一年中使用门户网站 12 个月与 HbA1c 年度下降 -0.41%（95% 置信区间 [CI]，-0.46% 至 -0.36%）和 LDL 年度下降 -6.25（ 95% CI，-7.15 至 -5.36) mg/dL。使用门静脉 12 个月与血压改善最小相关：收缩压为 -1.01（95% CI，-1.33 至 -0.68）毫米汞柱，舒张压为 -0.67（95% CI，-0.85 至 -0.49）毫米汞柱. 对于在基线时控制这些措施的患者，所有关联都较小或不存在。

结论

我们发现在新的门户用户中持续使用患者门户与基线时风险增加的患者的平均 HbA1c 和 LDL 的适度改善相关。对于 2 型糖尿病患者，在线患者门户支持的自我管理可能有助于控制 HbA1c、LDL 和 BP。