Online patient portal boosts diabetes medication adherence

Diabetic patients who used an online patient portal to refill medications increased their medication adherence and improved cholesterol levels, according to a Kaiser Permanente study published in a recent issue of Medical Care.

"Medication adherence and other health behaviors are often the hardest things for a health care system to influence," said senior author Andrew J. Karter, PhD, research scientist at the Kaiser Permanente Division of Research in Oakland, Calif. "Offering patients the option of ordering prescription refills online may create efficiencies for pharmacy operations, convenience for patients, and also improvements in adherence and health."

The study, led by Urmimala Sarkar, MD, an assistant professor at University of California San Francisco, followed 17,760 patients with diabetes who received care from Kaiser Permanente in Northern California between January 2006, and December 2010. The patients studied had an average of more than 6 chronically used medications and 11 outpatient visits per year.

All patients were registered users of Kaiser Permanente’s personal health record, My Health Manager, and had been prescribed cholesterol-lowering medications. The study subjects were divided into 3 groups based on their use of the portal to order refills of their cholesterol-lowering medications: the control group included those who never used the online refill function; "occasional users," who requested medication refills through the Kaiser Permanente patient portal at least once (but not always); and "exclusive users" who requested all of their refills through the patient portal.

The cholesterol-lowering medications studied are widely prescribed for patients with diabetes.

The researchers found that 8,705 subjects in the study initiated the online refill function use, including "exclusive" and "occasional" users (ie, requesting all vs some refills online, respectively). Nonadherence declined by an absolute 6% among exclusive users, without significant changes among occasional users. Similar LDL cholesterol decreases were also seen among exclusive users.

"This research is an important step in understanding the benefits of portals beyond convenience. Given the clear connection between medication adherence and improved health outcomes, this study provides insight into how online portals may improve health outcomes,” Dr Sarkar said.