A Theory-Based Patient Portal eLearning Program for Older Adults With Chronic Illnesses

NCT03242070 | Completed

• 1 other identifier: HP-00069040
• Study Type: interventional
• Target: 276
• Locations: 1 country
• Sites: 1

Brief Summary

The high prevalence of chronic illnesses is a serious public health problem in the U.S., and more than 70 million adults age ≥50 have at least one chronic illness. Management of chronic conditions requires long-term use of complex treatment plans and can cause unintended consequences, such as increased risk of medication errors. Patient portals (PPs), a federally supported health information technology (IT), can be especially helpful for patients with chronic illnesses. Patients can now access their own health records and directly communicate with care providers through PPs. Prior findings suggest a great potential for using PPs to improve care quality, and the federal government funds healthcare organizations to implement this tool nationwide. Despite the potential benefits, the overall PP adoption rate in the U.S. is low. A lack of PP use among older adults has been addressed as a particular concern. When only older adults who use the Internet are considered, however, their proportion of PP use is similar to other age groups. A few studies also reported that older adults are receptive to PPs. In general, older adults need additional support for learning to use PPs, as they tend to be less familiar with technology. Currently, most older adults receive little or no PP support from their providers. This is an important gap in the nation's health IT initiative because without appropriate support, older adults will not be able to use this robust health tool, missing an important opportunity to improve their health outcomes. In an effort to fill this gap, the investigators developed and tested an older adult friendly Theory-based Patient portal eLearning Program (T-PeP) to support older adults in using PPs for their care. In the proposed feasibility study, the investigators plan to (Aim 1) optimize and implement a vendor-agnostic T-PeP and conduct formative and process evaluations; and (Aim 2) assess the preliminary impact of T-PeP on PP use and selected outcomes (PP knowledge, self-efficacy for PP use and health decision making, health communication, and medication reconciliation). If successful, this study could directly affect quality of care provided to older adults and the success of the national health IT initiative. Findings from this study will also provide hospitals, vendors, and policymakers with in-depth information on older adults' current PP usage patterns and other challenges in using various types of PPs at the national level.

Conditions

Patient Portals; Chronic Disease; Older Adults

Keywords

Patient Portals; Chronic Disease; Older Adults

Outcome Measures

Primary Outcomes (5)

• PP knowledge

  An 8-item questionnaire developed by experts and tested in preliminary studies (α=.50).40,41

  Change from baseline knowledge at 3 week and 4 months

• Self-efficacy for using PPs

  a modified 4-item Self-Efficacy for Computer-Based PHR Scale100 (α=.97; criterion validity), which was successfully used in our preliminary studies.40,41

  Change from baseline knowledge at 3 week and 4 months

• Self-efficacy for health decision making

  Decision Self-Efficacy Scale, including 11 items on a 5-point Likert scale. The scale assesses the person's ability to obtain information, ask questions, and make a choice.136-138 It was tested for older adults in an eHealth study (α=.83; criterion validity).139

  Change from baseline knowledge at 3 week and 4 months

• Patient-provider communication

  14 items of the Components of Primary Care Instrument140,141 that assesses the following 3 areas: interpersonal communication, physician's knowledge of the patient, coordination of care. This tool has been tested in our prior study40 (α=.89; factor analysis141).

  Change from baseline knowledge at 3 week and 4 months

• PP use

  The number of newly activated account(s) and the frequency of PP usage per function; lab results, medications, and health summaries; and other functions as reported in the scheduled surveys.

  Change from baseline knowledge at 3 week and 4 months

Secondary Outcomes (1)

• Medication reconciliation

  Change from baseline knowledge at 3 week and 4 months

Study Arms (2)

Theory-based PP eLearning Program(T-PeP)

EXPERIMENTAL

Theory-based PP eLearning Program (T-PeP) was developed based on self-efficacy theory42-44 to improve older adults' use of PPs for managing their care and includes learning modules, discussion boards, and other resources. Considering variations in the types and usability of PPs used by patients nationwide, T-PeP was developed as a vendor-agnostic ("not tied to a specific vendor") program.

Other: Theory-based PP eLearning Program(T-PeP)

Control Group

NO INTERVENTION

No specific intervention will be provided to the control group participants

Interventions

Theory-based PP eLearning Program(T-PeP) OTHER

Theory-based PP eLearning Program (T-PeP) was developed based on self-efficacy theory42-44 to improve older adults' use of PPs for managing their care and includes learning modules, discussion boards, and other resources. Considering variations in the types and usability of PPs used by patients nationwide, T-PeP was developed as a vendor-agnostic ("not tied to a specific vendor") program.

Theory-based PP eLearning Program(T-PeP)

Eligibility Criteria

• Age: 50 Years+
• Sex: all
• Healthy Volunteers: Yes
• Age Groups: Adult (18-64), Older Adult (65+)

You may qualify if:

• being age ≥50
• having been diagnosed with at least one chronic disease\* (e.g., heart disease, diabetes, cancer)
• having access to the Internet/e-mail
• being able to use the Internet/e-mail independently
• currently residing in the U.S.
• being able to read/write English.

Sponsors & Collaborators

• University of Maryland, Baltimore: lead
• Agency for Healthcare Research and Quality (AHRQ): collaborator

Study Sites (1)

SeniorNet

Fort Myers, Florida, 33907, United States

Location

MeSH Terms

Conditions

Chronic Disease

Condition Hierarchy (Ancestors)

Disease Attributes; Pathologic Processes; Pathological Conditions, Signs and Symptoms

Study Design

• Study Type: interventional
• Phase: not applicable
• Allocation: RANDOMIZED
• Masking: NONE
• Purpose: SUPPORTIVE CARE
• Intervention Model: PARALLEL
• Sponsor Type: OTHER
• Responsible Party: PRINCIPAL INVESTIGATOR
• PI Title: Professor

Model Details: A two-arm parallel-group RCT

Study Record Dates

• First Submitted: August 2, 2017
• First Posted: August 8, 2017
• Study Start: January 17, 2017
• Primary Completion: December 31, 2017
• Study Completion: June 30, 2019
• Last Updated: May 23, 2022

Record last verified: 2022-05

Data Sharing

• IPD Sharing: Will not share

Locations

US (1)