背景:患者门户有可能通过参与慢性病患者的治疗来改善对他们的护理。这些平台可以工作,例如,作为独立的自我管理干预措施或在常规护理中与治疗提供者的连接。许多不同类型的门户可用于不同的患者群体,提供各种功能。
目的:本范围综述旨在总结目前关于糖尿病和慢性心脏病患者使用行为和可用性的患者门户的文献。
方法:我们根据PRISMA(系统审查和荟萃分析的首选报告项目)声明进行了本次审查。我们使用PubMed进行数据库搜索,PsycInfo,和CINAHL,以及评论和参考列表中的其他搜索。我们将搜索限制在2010年。定性和定量研究,使用两种方法分析患者门户的使用行为或可用性的研究均符合条件。我们根据广泛的主题类别绘制了门户特征,并根据结果和研究设计分别总结了纳入研究的结果。
结果:筛选后,我们最终纳入了85项研究。大多数研究是关于糖尿病患者,包括65岁以下的患者,并在美国进行。门户功能分为教育/一般信息,提醒,监测,交互性,个人健康信息,电子/个人健康记录,和沟通。门户网站主要提供教育,监测,和通信相关的功能。研究报告了使用行为,包括相关变量,可用性维度,和改进建议。确定了报告使用频率的各种方式。经常报告门户使用率随着时间的推移显着下降。年龄最常被研究与门户使用相关,其次是性别,教育,和电子健康素养。较年轻的年龄和较高的教育程度通常与较高的门户使用率有关。在三分之二报告门户可用性的研究中,门户网站被评为用户友好和易于理解,尽管测量和报告是异构的。门户被认为通过对动机的积极影响来帮助自我管理,健康意识,和行为变化。自我管理的有用功能是教育/一般信息和监控。门户使用的障碍是普遍的(例如,设计或一般可用性方面),与门户使用期间的特定情况有关(例如,登录程序),或不特定于门户(例如,用户技能和偏好)。频繁的主题是设计的方面,可用性,和技术。改进建议主要涉及技术问题和需要支持。
结论:目前的研究状态强调了患者参与患者门户开发和评估的重要性。在范围审查中考虑各种研究设计有助于更深入地了解使用行为和可用性。未来的研究应关注疾病负担的作用,以及老年患者的使用行为和可用性。
Patient portals have the potential to improve care for chronically ill patients by engaging them in their treatment. These platforms can work, for example, as a standalone self-management intervention or a tethered link to treatment providers in routine care. Many different types of portals are available for different patient groups, providing various features.
This scoping
review aims to summarize the current literature on patient portals for patients with diabetes mellitus and chronic heart disease regarding usage behavior and usability.
We conducted this
review according to the PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) statement for scoping reviews. We performed database searches using PubMed, PsycInfo, and CINAHL, as well as additional searches in reviews and reference lists. We restricted our search to 2010. Qualitative and quantitative studies, and studies using both approaches that analyzed usage behavior or usability of patient portals were eligible. We mapped portal features according to broad thematic categories and summarized the results of the included studies separately according to outcome and research design.
After screening, we finally included 85 studies. Most studies were about patients with diabetes, included patients younger than 65 years, and were conducted in the United States. Portal features were categorized into educational/general information, reminder, monitoring, interactivity, personal health information, electronic/personal health record, and communication. Portals mostly provided educational, monitoring, and communication-related features. Studies reported on usage behavior including associated variables, usability dimensions, and suggestions for improvement. Various ways of reporting usage frequency were identified. A noticeable decline in portal usage over time was reported frequently. Age was most frequently studied in association with portal use, followed by gender, education, and eHealth literacy. Younger age and higher education were often associated with higher portal use. In two-thirds of studies reporting on portal usability, the portals were rated as user friendly and comprehensible, although measurement and reporting were heterogeneous. Portals were considered helpful for self-management through positive influences on motivation, health awareness, and behavioral changes. Helpful features for self-management were educational/general information and monitoring. Barriers to portal use were general (eg, aspects of design or general usability), related to specific situations during portal use (eg, login procedure), or not portal specific (eg, user skills and preferences). Frequent themes were aspects of design, usability, and technology. Suggestions for improvement were mainly related to technical issues and need for support.
The current state of research emphasizes the importance of involving patients in the development and evaluation of patient portals. The consideration of various research designs in a scoping
review is helpful for a deeper understanding of usage behavior and usability. Future research should focus on the role of disease burden, and usage behavior and usability among older patients.