Researchers: Orna Baron Epel¹

Background: Diabetes is a complex chronic illness with a number of complications increasing around the world. Digital means show great promise to help individuals manage their illness. Clalit Health Services offers rich online services to their patients.

Objectives: To identify and characterize promoting factors and barriers to use of the online services and the association between online registration status and demographic characteristics, environmental factors and treatment outcomes.

Method: A mixed-method study examining diabetes patients insured by Clalit Health Services included 3 parts: 1, Qualitative interviews with 10 diabetes patients; 2. Analysis of the database of 136,332 diabetes patients; 3. A telephone survey of 943 patients.

Findings: Attitudes towards diabetes, self-rated health, and trust in the health system were found to promote the use of online services in the qualitative study. The factors associated to registration to the online services were younger age, duration of diabetes, living in the periphery, and gender. A significant association was found between registration status to the online services among diabetes patients and compliance to pharmacological treatment, follow-up visits with doctors, carrying out routine tests and controlled diabetes. These associations remained significant after controlling for age, duration of the diabetes, socioeconomic status, and geographic location.

Conclusions: Registration status is positively correlated with desirable health outcomes and health behaviors.

Recommendations: There is a need for proactive actions so those with no access to online services will receive assistance in registering to the on line services in order for them to be able to improve their health. In addition, there is a need to improve positive attitudes and perceptions towards the disease among diabetes patients.

Research end date: 02/2021