Transforming Nursing and healthcare Through Technology Paper

Patient Portal and Effective Blood Pressure Control

This annotated bibliography will review the application of patient portal system and how it enhances patient blood pressure management/control. The content of each journal article will be summarized in terms of the objectives, outcomes, implications for practice and application towards improving patient blood pressure management. Specific examples will be used to demonstrate the soundness and relevance of the evidence. Based on 4 peer-reviewed journal articles, the journal articles will be those published from the year 2017 to date to guarantee relevance. after the annotated bibliography, the conclusion section will identify and synthesize the evidence from the four journal articles.

Transforming Nursing and healthcare Through Technology Paper

Article 1

Coughlin, S. S., Prochaska, J. J., Williams, L. B., Besenyi, G. M., Heboyan, V., Goggans, D. S., Yoo, W. & De Leo,G. (2017). Patient web portals, disease management, and primary prevention. Risk Management And Healthcare Policy, 10, 33. doi: 10.2147/RMHP.S130431

This article focused on the use of web portals in disease management and prevention. Coughlin et al. (2017) contend that efforts to reform the healthcare sectors through new technology has contributed to increased attention of both practitioners and academicians on patient web portals. Web portals collet information from different sources in a uniform way to allow health institutions to deliver more consistent feel and look for multiple information, content and applications from different databases. They are password protected and offer 24-hour access to patient’s personal health information anywhere. However, as per Coughlin et al (2017 Transforming Nursing and healthcare Through Technology Paper), previous review studies have omitted the recent published research on how web portals can facilitate disease management and prevention.

Coughlin et al. (2017) conducted a bibliographic search on PubMed to identify and review evidence on web portals and their role in primary and secondary disease management and prevention. The study focused on patient web portals integrated with electronic medical records, health disparities, as well as disease-specific portals.  The results showed that patient web portals are effective in chronic disease management. Specifically, some of the reviewed studies by Coughlin et al (2017) indicated that diabetic patients with uncontrolled blood pressure who used web-based refills were more likely to achieve blood pressure control at follow up that those who did not use web-based refills.  The review approach used by Coughlin et al (2017) as well as their findings present as a good source of evidence for practice as it can be used to encourage better blood pressure control in diabetes.

Article 2

Aljabri, D., Dumitrascu, A., Burton, M. C., White, L., Khan, M., Xirasagar, S., Horner, R. & Naessens, J. (2018). Patient portal adoption and use by hospitalized cancer patients: a retrospective study of its impact on adverse events, utilization, and patient satisfaction. BMC Medical Informatics And Decision Making, 18(1), 1-12. https://doi.org/10.1186/s12911-018-0644-4

The study by Aljabri et al. (2018) focuses on the primary argument that much as the use of patient web-based portals have been studies among outpatients, there is still a paucity of evidence to validate the impact of its utility on inpatients. As such, the study’s main aim was to evaluate portal adoption and use among hospitalised cancer patients and its association with patient’s satisfaction measures, utilization and safety.

The authors conducted a retrospective review of 4594 cancer adults in hospitals between the year 2012 to 2014, comparing portal adopters and non-adopters. Aljabri et al. (2018) then used linear regression, univariate and several logistics models to analyse the data. The results showed that adopters of patient-portals had better self-management knowledge compared to non-adopters. Specifically, the univariate analysis revealed that among chronically ill patients, the use of portal was associated with improved diabetic satisfaction with care, better adherence to treatments and better self-management.

Aljabri et al. (2018) also found evidence of better blood pressure control among people with newly diagnosed hypertension who adopted web-portals. The findings by Aljabri et al. (2018 Transforming Nursing and healthcare Through Technology Paper) are relevant not only to the practice of diabetes management but also to the management of early-stage hypertension especially in the case where practitioners have the option of adopting patient web-portals.

Article 3

Price-Haywood, E. G., Luo, Q., & Monlezun, D. (2018). Dose effect of patient–care team

communication via secure portal messaging on glucose and blood pressure control. Journal of the American Medical Informatics Association, 25(6), 702-708. https://doi.org/10.1093/jamia/ocx161

Price-Haywood et al. (2017) hypothesised that the use of patient portal messaging can not only improve patient-provider communication but also health outcomes. To validate these assumptions, they conducted a study to evaluate the dose effect of patient-practitioner communication through secure portal messaging on glucose and blood pressure control.

The retrospective cohort analysis study involved 101,019 hypertensive and diabetic patients, 11138 of them being active portal users receiving primary care. Price-Haywood et al. (2017) used propensity-score adjusted multivariate fixed affects regression panel analysis to evaluate the association between the intensity of using medical advice portal messaging and blood pressure/glucose control.

The study results indicated a dose-response effect of medical advice portal messaging on glucose control in the sense that compared to non-portal users, each level of messaging among portal users was associated with greater decrease in HbA1c. However, there was no effect of medical advice portal on blood pressure. As such, the study concluded that after accounting for service utilization and sociodemographic, portal use is no longer associated with blood pressure improvements. These findings are especially important in revealing that not only the use of portals by patient is important, but also how the patient use the portals.

Article 4

Sun, R., Korytkowski, M. T., Sereika, S. M., Saul, M. I., Li, D., & Burke, L. E. (2018). Patient portal use in diabetes management: literature review. JMIR Diabetes, 3(4), e11199. doi: 10.2196/11199

Sun et al. (2018) hypothesized that information technology tools such as can promote patient-provider communication, enhance engagement and promote positive clinical outcomes for patients with chronic diseases such as diabetes and hypertension. To validate their hypothesis, they conducted and published a peer-reviewed literature review study to evaluate existing evidence on patient portal use by type 1 diabetes patients.

The study relied on electronic search of literature materials from online databases such as PsychINFO and PubMed. The search strategy revealed 16 observational studies, 6 randomized control trials, 4 mixed method studies and 4 qualitative studies that were admitted for further review. Results revealed that the use of patient portal accounts was associated with technology (usability and functionality), personal traits (clinical characteristics and sociodemographic), and service provider engagement.

Whereas there were inconsistent findings on the relationship between patient portal and some diabetes mellitus clinical characteristics, other reviewed studies found an association between patient portal and ease of recording blood pressure readings. According to Sun et al. (2018), this facilitates easier blood pressure management because it enhances informed decision-making and easier changes of therapy by physicians. The findings of this article present many opportunities for improving diabetes care through patient portal because it identifies and synthesizes evidence from a variety of studies conducted in the past ten years.

Conclusion

It is important to note that all the four studies contribute useful information of blood pressure control. Three of the studies reveal that patient portal can facilitate adherence to medication interventions and lifestyle behaviors and choices. Similarly, they enhance patient-provider communication. All the four studies consider communication as an important aspect of chronic illness care especially regarding self-management knowledge. Nonetheless, one study, that of Price-Haywood et al. (2017), found no effect of medical advice portal on blood pressure, revealing that it is not enough to establish patient portal use, there is need to monitor how the patient use it to yield positive results.

References for Transforming Nursing and healthcare Through Technology Paper

  • Aljabri, D., Dumitrascu, A., Burton, M. C., White, L., Khan, M., Xirasagar, S., Horner, R. & Naessens, J. (2018). Patient portal adoption and use by hospitalized cancer patients: a retrospective study of its impact on adverse events, utilization, and patient satisfaction. BMC Medical Informatics And Decision Making, 18(1), 1-12. https://doi.org/10.1186/s12911-018-0644-4
  • Coughlin, S. S., Prochaska, J. J., Williams, L. B., Besenyi, G. M., Heboyan, V., Goggans, D. S., Yoo, W. & De Leo,G. (2017). Patient web portals, disease management, and primary prevention. Risk Management And Healthcare Policy, 10, 33. doi: 10.2147/RMHP.S130431
  • Price-Haywood, E. G., Luo, Q., & Monlezun, D. (2018). Dose effect of patient–care team communication via secure portal messaging on glucose and blood pressure control. Journal of the American Medical Informatics Association, 25(6), 702-708. https://doi.org/10.1093/jamia/ocx161
  • Sun, R., Korytkowski, M. T., Sereika, S. M., Saul, M. I., Li, D., & Burke, L. E. (2018). Patient portal use in diabetes management: literature review. JMIR Diabetes, 3(4), e11199. doi: 10.2196/11199