Ignite Creation Date:
2024-05-06 @ 10:23 AM
Last Modification Date:
2024-10-26 @ 12:29 PM
Study NCT ID:
NCT03242070
Status:
COMPLETED
Last Update Posted:
2022-05-23
First Post:
2017-08-02
Brief Title:
A Theory-Based Patient Portal eLearning Program for Older Adults With Chronic Illnesses
Sponsor:
University of Maryland Baltimore
Organization:
University of Maryland Baltimore
Study Overview
Official Title:
A Theory-Based Patient Portal eLearning Program for Older Adults With Chronic Illnesses
Status:
COMPLETED
Status Verified Date:
2022-05
Last Known Status:
None
Delayed Posting:
No
If Stopped, Why?:
Not Stopped
Has Expanded Access:
False
If Expanded Access, NCT#:
N/A
Has Expanded Access, NCT# Status:
N/A
Acronym:
None
Brief Summary:
The high prevalence of chronic illnesses is a serious public health problem in the US 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 US 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 nations 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
Detailed Description:
The high prevalence of chronic illnesses is a serious public health problem in the United States accounting for 70 of all deaths Older adults are especially vulnerable more than 70 million adults age 50 have at least one chronic illness eg heart disease diabetes Management of chronic conditions requires long-term use of multiple medications and complex treatment plans which can cause unintended consequences such as increased risk of medication errors Engaging patients in their care and health decision-making processes is vital for the provision of high quality care to people with chronic conditions Until recently however patients were not given access to their own health records and had to call their providers offices to communicate with them In the past few years the nation has made unprecedented efforts to transform health care using information technology IT Through secure patient portals PPs patients now can access their electronic health records EHRs directly send eMessages to their providers and request medication renewals online They can also involve their family caregivers in their care more efficiently PPs are especially helpful for patients with chronic illnesses as they offer tools to manage health conditions With the Meaningful Use MU incentive payment program by the Centers for Medicare and Medicaid Services CMS healthcare organizations nationwide are implementing PPs and making them available to the public
Prior findings demonstrated positive impacts of PPs on management of chronic conditions adherence to treatment and patient-provider communication Currently PP adoption rates vary depending on care organizations but the overall nationwide adoption rate has been low 268 A lack of PP use among older adults has been addressed as a particular concern Based on 2014 national survey data however when only online users were considered the proportion of PP use in older adults was similar to other age groups 18 yrs 322 50-64 341 65 298 In a 2015 SeniorNet34 member survey N553 mean age 736 yrs 606 n327 reported having at least one PP account These findings indicate an excellent potential for using PPs for the care of older adults AHRQs priority population36 Many older adults however are not technologically savvy and need additional support Currently most older adults receive little or no PP training support from their providers This is a critical gap in the nations 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-related outcomes
In an effort to fill this gap in our previous studies the investigators developed and tested the older adult friendly Theory-based PP eLearning Program T-PeP to provide older adults necessary support for using PPs In the proposed feasibility study the investigators will optimize and implement the program in a large older adult online community conduct formativeprocess evaluation and assess its preliminary impact on PP use and selected health-related outcomes T-PeP was developed based on self-efficacy theory 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 The specific aims of the study are to
Aim 1 Optimize and implement T-PeP in an older adult online community and conduct formative and process evaluations eg usability problems barriers and facilitators for PP use and other practical issues
Aim 2 Assess the preliminary impact of T-PeP on older adults PP use and selected health-related outcomes using a two-arm randomized controlled trial RCT Older adult online users with chronic conditions N242 age 50 will be recruited from a large older adult online community SeniorNetorg
H1 The intervention group participants will demonstrate greater improvement than the control group at the end of T-PeP 3 weeks and at 4 months in PP knowledge self-efficacy for using PPs and making health decisions perceived patient-provider communication and PP use enrollment usage frequency
H2 More participants in the intervention group than the control group will reconcile the medications they are taking with the medications listed in their PP at 4 months
This study could directly impact quality of care provided to older adults and the success of a national health IT initiative by offering a critically missing component in the current PP implementation process-patient support for the health IT PP designed for patients Findings from the study will also provide hospitals vendors and policymakers in-depth information on older adults current PP usage patterns and other challenges in using various PPs at the national level contributing to the improvement of PP technology and clinical practices Once the feasibility of the study is demonstrated the vendor-agnostic T-PeP could be used widely and incorporated into busy practices The next R01 study will test its long-term effects on health behavior and clinical outcomes as well as care cost using more diverse samples including practice settings and underserved populations
Prior findings demonstrated positive impacts of PPs on management of chronic conditions adherence to treatment and patient-provider communication Currently PP adoption rates vary depending on care organizations but the overall nationwide adoption rate has been low 268 A lack of PP use among older adults has been addressed as a particular concern Based on 2014 national survey data however when only online users were considered the proportion of PP use in older adults was similar to other age groups 18 yrs 322 50-64 341 65 298 In a 2015 SeniorNet34 member survey N553 mean age 736 yrs 606 n327 reported having at least one PP account These findings indicate an excellent potential for using PPs for the care of older adults AHRQs priority population36 Many older adults however are not technologically savvy and need additional support Currently most older adults receive little or no PP training support from their providers This is a critical gap in the nations 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-related outcomes
In an effort to fill this gap in our previous studies the investigators developed and tested the older adult friendly Theory-based PP eLearning Program T-PeP to provide older adults necessary support for using PPs In the proposed feasibility study the investigators will optimize and implement the program in a large older adult online community conduct formativeprocess evaluation and assess its preliminary impact on PP use and selected health-related outcomes T-PeP was developed based on self-efficacy theory 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 The specific aims of the study are to
Aim 1 Optimize and implement T-PeP in an older adult online community and conduct formative and process evaluations eg usability problems barriers and facilitators for PP use and other practical issues
Aim 2 Assess the preliminary impact of T-PeP on older adults PP use and selected health-related outcomes using a two-arm randomized controlled trial RCT Older adult online users with chronic conditions N242 age 50 will be recruited from a large older adult online community SeniorNetorg
H1 The intervention group participants will demonstrate greater improvement than the control group at the end of T-PeP 3 weeks and at 4 months in PP knowledge self-efficacy for using PPs and making health decisions perceived patient-provider communication and PP use enrollment usage frequency
H2 More participants in the intervention group than the control group will reconcile the medications they are taking with the medications listed in their PP at 4 months
This study could directly impact quality of care provided to older adults and the success of a national health IT initiative by offering a critically missing component in the current PP implementation process-patient support for the health IT PP designed for patients Findings from the study will also provide hospitals vendors and policymakers in-depth information on older adults current PP usage patterns and other challenges in using various PPs at the national level contributing to the improvement of PP technology and clinical practices Once the feasibility of the study is demonstrated the vendor-agnostic T-PeP could be used widely and incorporated into busy practices The next R01 study will test its long-term effects on health behavior and clinical outcomes as well as care cost using more diverse samples including practice settings and underserved populations
Study Oversight
Has Oversight DMC:
None
Is a FDA Regulated Drug?:
False
Is a FDA Regulated Device?:
False
Is an Unapproved Device?:
None
Is a PPSD?:
None
Is a US Export?:
None
Is an FDA AA801 Violation?:
None