Patient portal use and blood pressure control in newly diagnosed hypertension

William Manard, Jeffrey F. Scherrer, Joanne Salas, F. David Schneider

Research output: Contribution to journalArticle

8 Citations (Scopus)

Abstract

Background: Current evidence that patient portal use improves disease management is inconclusive. Randomized controlled trials have found no benefit of Web-based patient-provider communication for blood pressure (BP) control, but patients from these studies were not selected for uncontrolled hypertension, nor did measures of portal use occur in a real-world setting, as captured in the electronic medical record. This study determined whether patient portal use by patients with treated, incident hypertension was associated with achieving BP control. Methods: Between 2008 to 2010, 1571 patients with an incident hypertension diagnosis, ages 21 to >89 years, were identified from an academic medical center primary care patient data registry. Cox proportional hazard models were computed to estimate the association between portal use and incident BP control during follow-up (2011-2015), before and after adjusting for covariates. Covariates included sociodemographics, smoking, obesity and other physical and mental health comorbidities, and volume of health care utilization. Results: After adjusting for age, portal users were more likely than nonusers to achieve BP control (hazard ratio, 1.24; 95% confidence interval, 1.06-1.45). After adjustment for sociodemographics, portal use was no longer associated with BP control (hazard ratio, 0.98; 95% confidence interval, 0.83-1.16). Conclusions: Patient sociodemographic factors, including race, sex, and socioeconomic status, account for the observation that portal use leads to BP control among persons with newly diagnosed hypertension. Further research is warranted to determine whether there are benefits of portal use for other chronic conditions.

Original languageEnglish (US)
Pages (from-to)452-459
Number of pages8
JournalJournal of the American Board of Family Medicine
Volume29
Issue number4
DOIs
StatePublished - Jul 1 2016

Fingerprint

Portal Pressure
Blood Pressure
Hypertension
Safety Management
Patient Acceptance of Health Care
Confidence Intervals
Electronic Health Records
Disease Management
Proportional Hazards Models
Social Class
Registries
Patient Portals
Comorbidity
Primary Health Care
Mental Health
Randomized Controlled Trials
Obesity
Smoking
Communication
Research

Keywords

  • Academic Medical Centers
  • Blood Pressure
  • Blood Pressure Determination
  • Chronic Disease
  • Comorbidity
  • Disease Management
  • Electronic Health Records
  • Follow-Up Studies
  • Hypertension
  • Internet
  • Mental Health
  • Obesity
  • Patient Care
  • Personal Health Records
  • Primary Health Care
  • Proportional Hazards Models
  • Randomized Controlled Trials as Topic
  • Registries
  • Smoking
  • Social Class

ASJC Scopus subject areas

  • Public Health, Environmental and Occupational Health
  • Family Practice

Cite this

Patient portal use and blood pressure control in newly diagnosed hypertension. / Manard, William; Scherrer, Jeffrey F.; Salas, Joanne; Schneider, F. David.

In: Journal of the American Board of Family Medicine, Vol. 29, No. 4, 01.07.2016, p. 452-459.

Research output: Contribution to journalArticle

Manard, William ; Scherrer, Jeffrey F. ; Salas, Joanne ; Schneider, F. David. / Patient portal use and blood pressure control in newly diagnosed hypertension. In: Journal of the American Board of Family Medicine. 2016 ; Vol. 29, No. 4. pp. 452-459.
@article{e1c4b27e94004c8d9d5d54ab3057943b,
title = "Patient portal use and blood pressure control in newly diagnosed hypertension",
abstract = "Background: Current evidence that patient portal use improves disease management is inconclusive. Randomized controlled trials have found no benefit of Web-based patient-provider communication for blood pressure (BP) control, but patients from these studies were not selected for uncontrolled hypertension, nor did measures of portal use occur in a real-world setting, as captured in the electronic medical record. This study determined whether patient portal use by patients with treated, incident hypertension was associated with achieving BP control. Methods: Between 2008 to 2010, 1571 patients with an incident hypertension diagnosis, ages 21 to >89 years, were identified from an academic medical center primary care patient data registry. Cox proportional hazard models were computed to estimate the association between portal use and incident BP control during follow-up (2011-2015), before and after adjusting for covariates. Covariates included sociodemographics, smoking, obesity and other physical and mental health comorbidities, and volume of health care utilization. Results: After adjusting for age, portal users were more likely than nonusers to achieve BP control (hazard ratio, 1.24; 95{\%} confidence interval, 1.06-1.45). After adjustment for sociodemographics, portal use was no longer associated with BP control (hazard ratio, 0.98; 95{\%} confidence interval, 0.83-1.16). Conclusions: Patient sociodemographic factors, including race, sex, and socioeconomic status, account for the observation that portal use leads to BP control among persons with newly diagnosed hypertension. Further research is warranted to determine whether there are benefits of portal use for other chronic conditions.",
keywords = "Academic Medical Centers, Blood Pressure, Blood Pressure Determination, Chronic Disease, Comorbidity, Disease Management, Electronic Health Records, Follow-Up Studies, Hypertension, Internet, Mental Health, Obesity, Patient Care, Personal Health Records, Primary Health Care, Proportional Hazards Models, Randomized Controlled Trials as Topic, Registries, Smoking, Social Class",
author = "William Manard and Scherrer, {Jeffrey F.} and Joanne Salas and Schneider, {F. David}",
year = "2016",
month = "7",
day = "1",
doi = "10.3122/jabfm.2016.04.160008",
language = "English (US)",
volume = "29",
pages = "452--459",
journal = "Journal of the American Board of Family Medicine",
issn = "1557-2625",
publisher = "American Board of Family Medicine",
number = "4",

}

TY - JOUR

T1 - Patient portal use and blood pressure control in newly diagnosed hypertension

AU - Manard, William

AU - Scherrer, Jeffrey F.

AU - Salas, Joanne

AU - Schneider, F. David

PY - 2016/7/1

Y1 - 2016/7/1

N2 - Background: Current evidence that patient portal use improves disease management is inconclusive. Randomized controlled trials have found no benefit of Web-based patient-provider communication for blood pressure (BP) control, but patients from these studies were not selected for uncontrolled hypertension, nor did measures of portal use occur in a real-world setting, as captured in the electronic medical record. This study determined whether patient portal use by patients with treated, incident hypertension was associated with achieving BP control. Methods: Between 2008 to 2010, 1571 patients with an incident hypertension diagnosis, ages 21 to >89 years, were identified from an academic medical center primary care patient data registry. Cox proportional hazard models were computed to estimate the association between portal use and incident BP control during follow-up (2011-2015), before and after adjusting for covariates. Covariates included sociodemographics, smoking, obesity and other physical and mental health comorbidities, and volume of health care utilization. Results: After adjusting for age, portal users were more likely than nonusers to achieve BP control (hazard ratio, 1.24; 95% confidence interval, 1.06-1.45). After adjustment for sociodemographics, portal use was no longer associated with BP control (hazard ratio, 0.98; 95% confidence interval, 0.83-1.16). Conclusions: Patient sociodemographic factors, including race, sex, and socioeconomic status, account for the observation that portal use leads to BP control among persons with newly diagnosed hypertension. Further research is warranted to determine whether there are benefits of portal use for other chronic conditions.

AB - Background: Current evidence that patient portal use improves disease management is inconclusive. Randomized controlled trials have found no benefit of Web-based patient-provider communication for blood pressure (BP) control, but patients from these studies were not selected for uncontrolled hypertension, nor did measures of portal use occur in a real-world setting, as captured in the electronic medical record. This study determined whether patient portal use by patients with treated, incident hypertension was associated with achieving BP control. Methods: Between 2008 to 2010, 1571 patients with an incident hypertension diagnosis, ages 21 to >89 years, were identified from an academic medical center primary care patient data registry. Cox proportional hazard models were computed to estimate the association between portal use and incident BP control during follow-up (2011-2015), before and after adjusting for covariates. Covariates included sociodemographics, smoking, obesity and other physical and mental health comorbidities, and volume of health care utilization. Results: After adjusting for age, portal users were more likely than nonusers to achieve BP control (hazard ratio, 1.24; 95% confidence interval, 1.06-1.45). After adjustment for sociodemographics, portal use was no longer associated with BP control (hazard ratio, 0.98; 95% confidence interval, 0.83-1.16). Conclusions: Patient sociodemographic factors, including race, sex, and socioeconomic status, account for the observation that portal use leads to BP control among persons with newly diagnosed hypertension. Further research is warranted to determine whether there are benefits of portal use for other chronic conditions.

KW - Academic Medical Centers

KW - Blood Pressure

KW - Blood Pressure Determination

KW - Chronic Disease

KW - Comorbidity

KW - Disease Management

KW - Electronic Health Records

KW - Follow-Up Studies

KW - Hypertension

KW - Internet

KW - Mental Health

KW - Obesity

KW - Patient Care

KW - Personal Health Records

KW - Primary Health Care

KW - Proportional Hazards Models

KW - Randomized Controlled Trials as Topic

KW - Registries

KW - Smoking

KW - Social Class

UR - http://www.scopus.com/inward/record.url?scp=84978877158&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=84978877158&partnerID=8YFLogxK

U2 - 10.3122/jabfm.2016.04.160008

DO - 10.3122/jabfm.2016.04.160008

M3 - Article

C2 - 27390376

AN - SCOPUS:84978877158

VL - 29

SP - 452

EP - 459

JO - Journal of the American Board of Family Medicine

JF - Journal of the American Board of Family Medicine

SN - 1557-2625

IS - 4

ER -