Patient Portal Frequency of Use in Patients with Hypertension and Diabetes

Electronic health records and patient portals allow patients to communicate with physicians and other members of the health care team. However, few studies have investigated the impact of these tools on chronic disease management. This study examines how patient portal activity can influence the management of type 2 diabetes (T2DM) and hypertension.

This is a retrospective cohort study from 2018 to 2022 of primary care encounters of large metropolitan health system patients 18 years old and older with a diagnosis of hypertension or T2DM. The primary exposure was total log-ins into the patient portal MyChart (Epic Systems Corporation, Verona, WI). Primary endpoints for hypertension were blood pressure (BP) < 140/90 mmHg, and T2DM was glycohemoglobin (HbA1c) ≤ 8% and tight control (HbA1c ≤ 7%). Multivariate logistic regression models were adjusted for age, ethnicity/race, sex, median household income, Charlson Comorbidity Index, training site status, and baseline disease control.

Regression results showed increased MyChart frequency increased the likelihood of having controlled T2DM (OR 1.77, P < .001). Having baseline BP < 140/90 mmHg or HbA1c control increased the likelihood of outcome control in all models. BP was less likely to be controlled at outcome in African Americans (OR 0.90, P < .001) and more likely to be controlled in males (OR 1.12, P < .001).

Increased patient portal usage is associated with greater likelihood of T2DM and hypertension control. Future studies should examine specific patient portal features, their usage and impact on health outcomes.