The Impact of Patient Characteristics on Their Attitudes Toward an Online Patient Portal for Communicating Laboratory Test Results: Real-World Study (Preprint)

Abstract

Patient portals are promising tools to increase patient involvement and allow them to manage their health. To optimally facilitate patients, laboratory test results should be explained in easy language. Patient characteristics affect the usage of portals and the user satisfaction. However, limited research is available, specified for online communicating laboratory test results, on whether portal use and acceptance differ between groups.

The aim of this study was to assess the effect of patient characteristics (gender, age, education, and chronic disease) on the self-efficacy and perceived usability of an online patient portal that communicates diagnostic test results.

We used the online-administered eHealth impact questionnaire (eHIQ) to explore patients’ attitudes toward the portal. Patients visiting the portal were asked to complete the questionnaire and to answer questions regarding gender, age, education, and chronic disease. The subscale “information and presentation” of the eHIQ assessed the usability of the patient portal and the subscale “motivation and confidence to act” assessed self-efficacy to determine whether patients were motivated to act on the presented information. Age, gender, education, and chronic disease were the determinants to analyze the effect on usability and self-efficacy. Descriptive analyses were performed to explore patient characteristics, usability, and self-efficacy. Univariable and multivariable regression analyses were performed with age, gender, education, and chronic disease as determinants, and usability and self-efficacy as outcomes.

The questionnaire was completed by 748 respondents, of which 428 (57.2%) were female, 423 (56.6%) were highly educated, and 509 (68%) had no chronic disease. The mean age was 58.5 years (SD 16.4). Higher age, high education, and asthma or chronic obstructive pulmonary disease were significant determinants for decreased usability; respectively, b=-.094, 95% CI -1147 to 0.042 (<i>P</i>&lt;.001); b=-2.512, 95% CI -4.791 to -0.232 (<i>P</i>=.03); and b=-3.630, 95% CI -6.545 to -0.715 (<i>P</i>=.02). High education was also a significant determinant for a lower self-efficacy (b=-3.521, 95% CI -6.469 to -0.572; <i>P</i>=.02). Other determinants were not significant.

This study showed that the higher-educated users of a patient portal scored lower on usability and self-efficacy. Usability was also lower for older people and for patients with asthma or chronic obstructive pulmonary disease. The results portal is not tailored for different groups. Further research should investigate which factors from a patient’s perspective are essential to tailor the portal for different groups and how a result portal can be optimally integrated within the daily practice of a doctor.