qLessons learned from patients with access to an online self-management enhancing program for RA patients: Qualitative analysis of interviews alongside a randomized clinical trial

At my own pace, space, and place: a systematic review of qualitative studies of enablers and barriers to telehealth interventions for people with chronic pain

“…Delivery of interventions comprised web-based, videoconference-based, telephone-based, video-based, smartphone app–based programs, used solely or in combination. Nine studies described interventions that were predominantly asynchronous, 6,17,32,37,59,62,66,69,86 5 were predominantly synchronous, 25,33,39,45,68 and 7 were hybrid. 8,21,34,41,46,73,79…”

“…The included studies were all in high-income countries: Australia (n = 4), 39,45,46,59 Netherlands (n = 4), 6,32,79,86 United Kingdom (n = 5), 17,33,34,69 Norway (n = 2), 37,41 Sweden (n = 2), 25,66 United States of America (n = 3), 21,62,68 and Switzerland (n = 1). 8 A visual framework was created to illustrate themes and subthemes interactions (Fig.…”

“…Hampered interaction between practitioners and patients created feelings of social disconnection and a lack of peer-support. 32 The subtheme "lack of context flexibility" was described in 5 studies in which interventions were delivered by the asynchronous mode (website, social media, or app), 6,59,62,66,86 and 4 studies in which interventions were delivered using a combination of synchronous and asynchronous modes (website and videoconference or telephone call). 34,41,46,73 The lack of content flexibility was perceived when the intervention was presented with limited scope for individual adaptations 46 and when participant expectations did not match intervention reality (eg, expectation of exercises vs reality of counselling).…”

Strategies for a safe and assertive telerehabilitation practice

“…Barriers to access telerehabilitation might include one or more of the following: a) lack of proper device (eg, computer or smartphone), b) lack of stable, good quality broadband internet, and/or c) low familiarity with technology. 15 , 27 In Brazil, the percentage of households with computers or notebooks has been dropping over the past 10 years in both urban and rural areas, despite the advance in internet access. 28 This contradiction is explained by the increase use of 3 G and 4 G technology through smartphones, 28 often accompanied by limited or prepaid internet package, not compatible with download of videos or video conferences.…”

“…28 This contradiction is explained by the increase use of 3 G and 4 G technology through smartphones, 28 often accompanied by limited or prepaid internet package, not compatible with download of videos or video conferences. In addition, low familiarity with technology might lead to difficulties of use 27 and a burden for the patient and the clinician. 15 Clinicians must be aware of patients’ background (ie, sociodemographic information and previous experiences with technology) to best design a telerehabilitation intervention that supports patient participation and engagement.…”