ArticleAnnals of family medicine2025
High Users of Primary Care Secure Messaging in the Veterans Health Administration.
Article in Annals of family medicine, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.
What it found
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
1 citing paper in PubMed.
- A scoping review of studies on secure messaging through patient portals: persistent challenges and potential solutions.npj health systems · 2026Article
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
7 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
purposeSecure messaging has increased in primary care, but we lack information on who uses it at a high level. Characterizing this population is important to inform policy about patients most likely to be affected by secure messaging reimbursement and coverage decisions; to contextualize the secure messaging work burden for primary care; and to understand how secure messaging complements use of other primary care access points. Our objectives were to describe characteristics of high users, assess their overall primary care and emergency department use, and determine the proportion of total Veterans Health Administration primary care messages exchanged by this group.
methodsWe conducted a 1-year retrospective cross-sectional analysis and multivariate logistic regression analysis of all veterans assigned to primary care on October 1, 2022 who exchanged at least 1 secure message with primary care by September 30, 2023. We calculated descriptive statistics and assessed whether certain veteran characteristics were associated with high user status (use in the 95th or higher percentile of all messages exchanged annually).
resultsPatients were more likely to be high users if they were older (adjusted odds ratio [aOR] for age ≥75 years = 2.49); had highest frailty (fourth quartile aOR = 2.65) or high physical comorbidity (Gagne score of 2 aOR = 1.17 and score of 3 aOR = 1.14); lived with schizophrenia or bipolar disorder (aOR = 1.23); or had posttraumatic stress disorder, anxiety, or depression (aOR = 1.16) (
conclusionsA small percentage of veterans exchange a disproportionate share of total secure messages. Most high users of secure messaging do not use other primary care or emergency department services at the same high frequency as secure messaging. High users commonly have high physical comorbidity, are frail, and live with mental health conditions, and racial disparities exist.
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Registered trials
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