Background Diabetes preventive care reduces complications, yet completion rates remain suboptimal. Patient portals may help close care gaps by enabling patients to initiate services, but their use for diabetes preventive care is understudied. Objective To evaluate the acceptability and feasibility of the Diabetes Care Gaps Intervention (DCGI), a portal-based tool that notifies patients when preventive care is due and enables them to initiate orders. Methods We conducted a single-arm pilot study at an academic medical center. Adult primary care patients with diabetes and ≥1 care gap (HbA1c, urine microalbumin, eye exam, or pneumococcal vaccine) received DCGI access for three months. Primary outcomes were usability (System Usability Scale, SUS) and user experience (qualitative interviews, Likert-scale items). Secondary outcomes included diabetes self-efficacy, distress, engagement (patient-initiated orders), and care gap closure. Participants received modest compensation for survey completion and first use of the DCGI to initiate or report care. Results Among 50 participants (median age 58.3 IQR: 45.9, 67.0, 52% female, and 40% from minoritized racial/ethnic groups), 78% (39/50) initiated or reported care through the DCGI. The median SUS score was 78.8 (IQR: 70.0, 90.0), significantly above the “good” usability threshold of 71 ( p =0.002). Interviews revealed two acceptability themes: (1) appreciation of the DCGI for helping keep up with preventive care, and (2) unease about using the DCGI due to limited portal confidence. Users showed improved diabetes self-efficacy and reduced distress. Of 110 total care gaps, 47 (43%) were addressed via patient-initiated orders, and 79% (37/47) led to completed care (gap closure). Conclusions The DCGI was acceptable and feasible for empowering patients to address diabetes care gaps. Future randomized studies should evaluate effectiveness and scalability.
Nelson et al. (Sun,) studied this question.