Perceptions of Patients With Chronic Obstructive Pulmonary Disease and Their Physiotherapists Regarding the Use of an eHealth Intervention

Abstract

BackgroundIf eHealth interventions are not used (properly), their potential benefits cannot be fulfilled. User perceptions of eHealth are an important determinant of its successful implementation. This study examined how patients with chronic obstructive pulmonary disease (COPD) and their physiotherapists (PHTs) value an eHealth self-management intervention following a period of use.ObjectiveThe study aimed to evaluate the perceptions of COPD patients and their PHTs as eHealth users.MethodsIn this study, an eHealth self-management intervention (website and mobile phone app) aimed at stimulating physical activity (PA) in COPD patients was evaluated by its users (patients and PHTs). As participants in a randomized controlled trial (RCT), they were asked how they valued the eHealth intervention after 6 months’ use. Interview requests were made to 33 PHTs from 26 participating practices, and a questionnaire was sent to 76 patients. The questionnaire was analyzed in Excel (Microsoft). The interviews with the PHTs and text messages (short message service, SMS) sent between patients and PHTs were transcribed and independently coded in MAXQDA 10 for Windows (VERBI GmbH).ResultsA total of 60 patients with COPD filled out the questionnaire, and 24 PHTs were interviewed. The mobile phone app was used 89.0% (160.2/180 days) (standard deviation [SD] 18.5) of the time by patients; 53% (13/24) of PHTs reported low or no use. Patients scored the ease of use of the app 5.09 (SD 1.14) (on a 7-point scale). They found the presentation of the PA information in the app to be clear, insightful, and stimulating. All PHTs judged the website as explicit and user-friendly but had trouble devising a new PA goal for their patients. Patients mostly sent informative, neutral messages concerning the PA goal, and PHTs sent mostly motivating, positive messages concerning the PA goal. Messages were not perceived as supportive in reaching the PA goal according to the patients. Perceived usefulness of the intervention for the PHTs was the objective measurement of PA, the ability to see PA patterns over time, and the ability to use the intervention as a tool to give their patients insight into their PA. For patients, it was that the intervention supported them in increasing their PA and that it made them feel fitter. Barriers to use of the intervention according to the PHTs were time constraints and financial reasons. Seventy-nine percent (19/24) of the PHTs and 58% (35/60) of the patients mentioned they would be interested in using the intervention in the future.ConclusionsPHTs and COPD patients had positive feelings regarding the functionality and potential of the eHealth self-management intervention. This paper addresses a number of topics that may aid in the successful development and implementation of these types of eHealth interventions in the future.

Smartphone-Based Physical Activity Telecoaching in Chronic Obstructive Pulmonary Disease: Mixed-Methods Study on Patient Experiences and Lessons for Implementation (Preprint)

“…This is in contrast to a 4-week pilot (telecoaching) study which showed a positive relationship between the degree of adherence of wearing a smartphone-based activity coach and the benefits from the intervention during the first two weeks albeit this association disappearing during the third week [10]. Despite a high degree of adherence with the PA telecoaching program (89.0% of the days used) in the trial by Vorrink and colleagues [20], the program was not able to induce significant improvements in PA [7]. The latter might be partly explained by the low degree of adherence of the primary care physiotherapists (due to financial reasons and time constraints) in using the foreseen website to adjust the patient's PA goals and to send motivating messages to the patients, which highlights the importance of introducing (semi-)…”

“…They had a positive perception and rated their satisfaction in line with previous PA telecoaching research in a mixed COPD and diabetes type 2 population [19]. As reported by others [20], the majority of patients stated that the PA telecoaching intervention in this trial coached them towards improving their PA.…”

Usefulness and Relevance of an eHealth Tool in Supporting the Self-Management of Chronic Obstructive Pulmonary Disease: Explorative Qualitative Study of a Cocreative Process

“…In this study, videos were suggested as important measures for communicating the self-management interventions as well as for addressing questions about the shame associated with a self-inflicted disease. Previously reported eHealth interventions have involved persuasive technologies such as remote monitoring of physical activity [ 21 ] and self-monitoring of health values [ 50 ], but no such components were suggested by the people with COPD in our study. However, the absence of such proposals and desires is hardly surprising as it might be necessary to have knowledge about such interventions in order to propose them.…”

“…Both people with COPD and physiotherapists (PTs) have been shown to perceive an eHealth self-management application that intends to increase physical activity by goal-setting, advises on how to perform physical activity, and presents physical activity in steps to be stimulating and beneficial. However, PTs reported a low use of the eHealth application because of time constraints and costs [ 21 ]. More knowledge is needed about how eHealth tools should be designed to support the aspects of self-management other than physical activity that will meet the needs and expectations of health professionals and people with COPD and their relatives.…”

Exploring the potential benefits of digital health technology for the management of COPD: a qualitative study of patient perceptions

“…However, several studies and systematic reviews have been published regarding telemonitoring, mHealth and eHealth interventions in the management of COPD, with sparse evidence demonstrating positive improvements for patient self-management or treatment outcomes [21][22][23][24][25]. Issues with the development of self-management digital health interventions in COPD and for chronic diseases in general have been discussed [22,26].…”