title: Patient Portal Use and Blood Pressure Control in Newly Diagnosed Hypertension.
abstract: Current evidence that patient portal use improves disease management is inconclusive. Randomized controlled trials have found no benefit of Web-based patient-provider communication for blood pressure (BP) control, but patients from these studies were not selected for uncontrolled hypertension, nor did measures of portal use occur in a real-world setting, as captured in the electronic medical record. This study determined whether patient portal use by patients with treated, incident hypertension was associated with achieving BP control.
  
  
  
  Between 2008 to 2010, 1571 patients with an incident hypertension diagnosis, ages 21 to >89 years, were identified from an academic medical center primary care patient data registry. Cox proportional hazard models were computed to estimate the association between portal use and incident BP control during follow-up (2011-2015), before and after adjusting for covariates. Covariates included sociodemographics, smoking, obesity and other physical and mental health comorbidities, and volume of health care utilization.
  
  
  
  After adjusting for age, portal users were more likely than nonusers to achieve BP control (hazard ratio, 1.24; 95% confidence interval, 1.06-1.45). After adjustment for sociodemographics, portal use was no longer associated with BP control (hazard ratio, 0.98; 95% confidence interval, 0.83-1.16).
  
  
  
  Patient sociodemographic factors, including race, sex, and socioeconomic status, account for the observation that portal use leads to BP control among persons with newly diagnosed hypertension. Further research is warranted to determine whether there are benefits of portal use for other chronic conditions.
authors.affiliation: From the Department of Family and Community Medicine, Saint Louis University School of Medicine, St. Louis, MO. manardwt@slu.edu.
authors.forename: William
authors.initials: W
authors.lastname: Manard
authors.affiliation: From the Department of Family and Community Medicine, Saint Louis University School of Medicine, St. Louis, MO.
authors.forename: Jeffrey F
authors.initials: JF
authors.lastname: Scherrer
authors.affiliation: From the Department of Family and Community Medicine, Saint Louis University School of Medicine, St. Louis, MO.
authors.forename: Joanne
authors.initials: J
authors.lastname: Salas
authors.affiliation: From the Department of Family and Community Medicine, Saint Louis University School of Medicine, St. Louis, MO.
authors.forename: F David
authors.initials: FD
authors.lastname: Schneider
mesh_terms: D000046:Academic Medical Centers / Q000379:methods*; D000368:Aged; D001794:Blood Pressure; D003142:Communication; D019468:Disease Management; D057286:Electronic Health Records; D005260:Female; D006801:Humans; D006973:Hypertension / Q000175:diagnosis / Q000628:therapy*; D008297:Male; D008875:Middle Aged; D000072638:Patient Portals / Q000706:statistics & numerical data*; D011320:Primary Health Care / Q000379:methods*; D012189:Retrospective Studies; D012959:Socioeconomic Factors
keywords: Academic Medical Centers; Blood Pressure; Blood Pressure Determination; Chronic Disease; Comorbidity; Disease Management; Electronic Health Records; Follow-Up Studies; Hypertension; Internet; Mental Health; Obesity; Patient Care; Personal Health Records; Primary Health Care; Proportional Hazards Models; Randomized Controlled Trials as Topic; Registries; Smoking; Social Class