Factors affecting the use of patient portals among chronically ill patients in an outpatient hospital setting, kingdom of Saudi Arabia

Background: In the light of the major healthcare transformations taking place in the Kingdom of Saudi Arabia (KSA), more focus is placed on promoting patient engagement to improve the quality of healthcare services provided. There is limited research that explores the factors related to the use of patient portals in KSA, which support patient engagement. We aimed to investigate factors that contribute to the use of a specific patient portal system, implemented at Prince Sultan Military Medical City, Riyadh, KSA among chronically ill patients in an outpatient setting. Method: A cross-sectional study was performed in the adult outpatient clinics. We included five main outcomes: self-reported portal use, participant characteristics, patient activation levels, e-Health literacy scores, and the availability of internet access at home. We used descriptive analyses, univariate and multivariate logistic regression to analyze the data. Results: A total of 403 patients (81% response rate) participated in our study. More than 50% of the participants were female, younger than 55 years, educated, with monthly family income less than 10, 000 SR. Most of the participants reported at least one form of internet connection. A total of 212 (52.6%) participants were users of the portal. Patient activation measure scores were at level 3 or below for the majority of participants (66%) and e-Health literacy scores were at a moderate to a high level for 276 (69%) of participants. Portal use was more likely among males (OR = 2.182, p = 0.00), with two or more forms of internet connections (OR = 5.586, p = 0.037), and with moderate to high levels of e-Health literacy (OR = 2.028, p = 0.003) (OR = 2.309, p = 0.022). There was a positive correlation between e-Health literacy scores and patient activation levels (R = 0.321, p = 0.000). Conclusion: Patient portal use was significantly influenced by certain factors, including gender, level of e-Health literacy and availability of internet. There is a tremendous opportunity to improve the use of patient portal by focusing on methods to increase the level of patient activation and e-Health literacy scores.