title: Use of an on-line patient portal in a depression collaborative care management program.
abstract: Evidence for patient portals on health outcomes is still accumulating.
  
  
  
  We performed a retrospective study of patients in a depression collaborative care management (CCM) program comparing dropout rates and outcomes at six months in patients who used the portal with their CCM managers versus those who did not use the portal for this purpose.
  
  
  
  1769 patients were analyzed, of which 272 (15.4%) used the portal to connect with their CCM managers. Portal users were more likely to be younger (mean age 37.8 years versus 42.6 years p<0.001), married (57.5% versus 48.2% p=0.003) and female (81% versus 69.4% p<0.001) compared to non-portal users. Completion of six month PHQ 9 forms was significantly higher in the portal group (75.7% vs. 65.7%, p=0.001) with an adjusted odds ratio (AOR) of 1.68 (1.25, 2.30, p<0.001). Using an intention to treat analysis, remission at 6 months was significantly higher in the portal group (45.2% vs 38.5%, p=0.038) with an AOR of 1.32 (1.00-1.73, p=0.47). However analysis of only those who completed a PHQ-9 at six months showed no difference in depression remission (59.7% vs 58.7%, p=0.78) with an AOR of 1.02 (0.75, 1.42. p=0.87). There was no difference in dropout rates between portal users compared to non-portal users (31.6% vs. 31.7%, p=0.97) with an AOR of 0.95 (0.71, 1.27, p=0.69).
  
  
  
  Limitations include the observational study design and a predominantly white study population.
  
  
  
  Use of a patient portal in depression CCM allows additional options for patients to participate without negatively influencing clinical outcomes.
authors.affiliation: Department of Family Medicine, Mayo Clinic Rochester, MN, USA. Electronic address: pecina.jennifer@mayo.edu.
authors.forename: Jennifer
authors.initials: J
authors.lastname: Pecina
authors.affiliation: Division of Primary Care Internal Medicine, Mayo Clinic Rochester, MN, USA.
authors.forename: Frederick
authors.initials: F
authors.lastname: North
authors.affiliation: Department of Psychiatry, Mayo Clinic Rochester, MN, USA.
authors.forename: Mark D
authors.initials: MD
authors.lastname: Williams
authors.affiliation: Department of Family Medicine, Mayo Clinic Rochester, MN, USA.
authors.forename: Kurt B
authors.initials: KB
authors.lastname: Angstman
mesh_terms: D000328:Adult; D003299:Cooperative Behavior; D003863:Depression / Q000628:therapy*; D003866:Depressive Disorder / Q000628:therapy*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D016017:Odds Ratio; D009862:Online Systems; D010358:Patient Participation / Q000706:statistics & numerical data*; D000072638:Patient Portals; D012189:Retrospective Studies
keywords: Collaborative care; Depression; On-line messaging; Patient portal