Development of an eHealth programme for self-management of persistent physical symptoms: a qualitative study on user needs in general practice

Abstract

Background Persistent physical symptoms (PPS) are estimated to be present in 17% of patients in general practice. Hence, general practitioners (GPs) play a key role in both the diagnostic assessment and the management of PPS. However, research indicates a need to improve their strategies to support self-help in patients, and eHealth tools may serve as an opportunity. This study aimed to explore patients’ and GPs’ needs related to self-management of PPS. The study was designed to inform the future development of eHealth interventions in this field. Methods This qualitative study was based on 20 semi-structured interviews (6 GPs and 14 patients with PPS). Interviews were audiotaped, transcribed verbatim and analysed through a five-step thematic analysis approach. First, we conducted an inductive analysis to identify and explore emerging subthemes. Second, using a deductive mapping strategy, we categorised the derived subthemes according to the COM-B behaviour change model and its three domains: capability, opportunity and motivation. Results We identified eleven subthemes in the patient interviews and seven subthemes in the GP interviews. Several unmet needs emerged. First, we identified a need to consider PPS early in the illness trajectory by taking a bio-psycho-social approach. Second, both patients and GPs need better skills to manage uncertainty. Third, hope is important for the patients. Fourth, patients need guidance from their GP in how to self-manage their PPS. Conclusions This study provides important insight into key issues and needs related to capability, opportunity and motivation that should be addressed in the design of future eHealth self-management interventions targeting patients with PPS in general practice in order to support and improve care.

Expectations of an Online-Self-Management Program for Rheumatoid Arthritis

“…Interactions with fellow patients have the benefit of providing a sense of comradery as a member of a group, which can help patients realize they are not alone with their disease (des Bordes et al, 2018; Dwarswaard et al, 2016). Rask et al (2021) also found that patients with chronic disease expressed a need for seeing other patients to learn how they successfully managed their daily life. Rask et al (2021) commented that it was of utmost importance to the patients that the online program offer hope, positive experiences, and effective strategies through interactions with their fellow patients.…”

“…Rask et al (2021) also found that patients with chronic disease expressed a need for seeing other patients to learn how they successfully managed their daily life. Rask et al (2021) commented that it was of utmost importance to the patients that the online program offer hope, positive experiences, and effective strategies through interactions with their fellow patients.…”

“…A Swedish study by Bywall et al (2019) reported patients with RA preferred to participate an online program because it was easier than painfully grasping a pen to write (Bywall et al, 2019). Moreover, the experts agreed that providing patients with easy access to self-management tools will promote their motivation (Rask et al, 2021).…”

“…Online self-management programs that include virtual visits allow more time for patient-provider dialog during consultations and have the potential to improve management of a chronic disease (Rask et al, 2021). Primary care providers (PCPs) of patients with chronic disease reported feeling the time allotted to in-person patient care was inadequate (Rask et al, 2021). These authors concluded an online self-management program could benefit both patients and PCPs by increasing patients’ access to information and reducing the time needed by PCPs for in-person discussions.…”

“…Online self-management programs that include virtual visits allow more time for patient-provider dialog during consultations and have the potential to improve management of a chronic disease (Rask et al, 2021). Primary care providers (PCPs) of patients with chronic disease reported feeling the time allotted to in-person patient care was inadequate (Rask et al, 2021).…”