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

Tistad, Malin; Lundell, Sara; Wiklund, Maria; Nyberg, André; Holmner, Åsa; Wadell, Karin

doi:10.2196/10801

Cited by 32 publications

(27 citation statements)

References 42 publications

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“…Therefore, including potential users at an early stage in the development process, so-called co-design [ 44 ], could be beneficial [ 45 ]. A recent study by Tistad et al [ 46 ] concludes that the involvement of user groups can strengthen the potential for a system to be adopted into everyday life and clinical practice. With this in mind, a weakness with our telemonitoring system is that the participants were not involved in its development.…”

Section: Discussionmentioning

confidence: 99%

Perceptions of Home Telemonitoring Use Among Patients With Chronic Obstructive Pulmonary Disease: Qualitative Study

Lundell

Modig

Holmner

et al. 2020

JMIR Mhealth Uhealth

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Background Chronic obstructive pulmonary disease (COPD) is a major health problem and an economic burden globally. There is growing interest in how electronic health (eHealth) can be used to provide efficient health care. Telemonitoring, where the patient’s health-related data is transmitted to a health care provider, can be used to detect early signs of exacerbations. A successful implementation of telemonitoring systems into clinical practice requires in-depth knowledge of the users’ preferences. Objective The aim of this study was to explore perceptions of the use of a home telemonitoring system among patients with COPD. Methods Semistructured individual interviews were carried out with 8 women and 5 men who were participants in a project aimed at developing and evaluating a telemonitoring system. The web-based telemonitoring system measured pulmonary function, subjective symptoms, and oxygen saturation. Participants were interviewed after having used the system for 2-4 months. Interview transcripts were analyzed with qualitative content analysis. Results The analysis resulted in the theme A transition toward increased control and security and four categories: using with (in)security, affecting technical concern or confidence, providing easy access to health care, and increasing control over the disease. The participants reported various perceptions of using the telemonitoring system. They expressed initial feelings of insecurity, both in terms of operating the system and in terms of their disease. However, the practical management of the telemonitoring system became easier with time; the participants gradually gained confidence and improved their self-management. New technology was perceived as an important complement to existing health care, but the importance of maintaining a human contact in real life or through the telemonitoring system was emphasized. Conclusions This study captured a transition among the participants from being insecure and experiencing technical concerns to acquiring technical confidence and improving disease management. Telemonitoring can be a valuable complement to health care, leading to increased self-knowledge, a sense of security, and improved self-management. Suggestions to improve the further development and implementation of telemonitoring systems include better patient education and the involvement of end users in the technical development process. Additional research is needed, particularly in the design of user-friendly systems, as well as in developing tools to predict which patients are most likely to find the equipment useful, as this may result in increased empowerment, improved quality of life, reduced costs, and a contribution to equity in health.

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Section: Discussionmentioning

confidence: 99%

Perceptions of Home Telemonitoring Use Among Patients With Chronic Obstructive Pulmonary Disease: Qualitative Study

Lundell

Modig

Holmner

et al. 2020

JMIR Mhealth Uhealth

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“…Nowadays, the rapid evolution of digital technology is leading to increased opportunities for self-management [9]. eHealth, for instance, provides the means to facilitate communication between care providers, and between care providers and their patients to exchange information and facilitate patients in self-monitoring [8], and is used to stimulate self-management in individuals with chronic disease [10,11,12,13]. For example, patients with chronic heart failure can monitor their own blood pressure and weight and communicate these data with their care provider.…”

Section: Introductionmentioning

confidence: 99%

Sociodemographic Factors Influencing the Use of eHealth in People with Chronic Diseases

Reiners

Sturm

Bouw

et al. 2019

IJERPH

200

152

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Alongside the growing number of older persons, the prevalence of chronic diseases is increasing, leading to higher pressure on health care services. eHealth is considered a solution for better and more efficient health care. However, not every patient is able to use eHealth, for several reasons. This study aims to provide an overview of: (1) sociodemographic factors that influence the use of eHealth; and (2) suggest directions for interventions that will improve the use of eHealth in patients with chronic disease. A structured literature review of PubMed, ScienceDirect, Association for Computing Machinery Digital Library (ACMDL), and Cumulative Index to Nursing and Allied Health Literature (CINAHL) was conducted using four sets of keywords: “chronic disease”, “eHealth”, “factors”, and “suggested interventions”. Qualitative, quantitative, and mixed-method studies were included. Four researchers each assessed quality and extracted data. Twenty-two out of 1639 articles were included. Higher age and lower income, lower education, living alone, and living in rural areas were found to be associated with lower eHealth use. Ethnicity revealed mixed outcomes. Suggested solutions were personalized support, social support, use of different types of Internet devices to deliver eHealth, and involvement of patients in the development of eHealth interventions. It is concluded that eHealth is least used by persons who need it most. Tailored delivery of eHealth is recommended.

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“…A detailed description of the COPD Web is available in the published protocol [14]. In brief, the COPD Web is an interactive web-page that was co-created with patients with COPD and their relatives, health professionals and experts in COPD management [6,13]. The COPD Web consists of two main sections – one directed at health professionals, and one directed at patients with COPD.…”

Section: Methodsmentioning

confidence: 99%

“…However, even though eHealth solutions have been suggested to have the potential to deliver support for self-management in patients with COPD, effects are inconsistent and further research is warranted [11,12]. Therefore, to further address this question, our research group have developed the COPD Web, an internet based eHealth tool aimed at facilitating support for self-management for patients with COPD through increasing the patients’ knowledge and skills [13,14]. The COPD Web has been co-created together with health professionals (asthma/COPD-nurses, physicians, occupational therapists, dieticians and physiotherapists), patients with COPD and their relatives and experts in pulmonary rehabilitation [6,13].…”

Section: Introductionmentioning

confidence: 99%

“…Therefore, to further address this question, our research group have developed the COPD Web, an internet based eHealth tool aimed at facilitating support for self-management for patients with COPD through increasing the patients’ knowledge and skills [13,14]. The COPD Web has been co-created together with health professionals (asthma/COPD-nurses, physicians, occupational therapists, dieticians and physiotherapists), patients with COPD and their relatives and experts in pulmonary rehabilitation [6,13]. However, before engaging on a definitive large-scale randomized controlled trial (RCT), conducting a pilot trial is highly recommended [15].…”

Section: Introductionmentioning

confidence: 99%

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Can the COPD web be used to promote self-management in patients with COPD in swedish primary care: a controlled pragmatic pilot trial with 3 month- and 12 month follow-up

Nyberg

Tistad

Wadell

2019

Scandinavian Journal of Primary Health Care

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Objective: Evaluate the feasibility of the COPD Web and its study design and study procedures and to increase the understanding of the potential effect of the tool in order to provide guidance for a future large scale trial. Design: Parallel-group controlled pragmatic pilot trial. Subjects: There was a total of 83 patients with COPD (mean age 70 ± 8 years with a forced expiratory volume in first second percent predicted of 60 ± 17%). The intervention group ( n = 43) was introduced to and had access to the COPD Web in addition to usual care, while the control group ( n = 40) received usual care alone. Main outcome measures: The feasibility of the COPD Web (i.e., if and how the COPD Web was used) was automatically collected through the website, while outcomes on health, conceptual knowledge, and physical activity (PA) were collected through questionnaires at baseline, 3 months and 12 months. Results: At 3 months, 77% of the intervention group was considered users, and the majority of time spent on the site was related to PA and exercises and was spent during the first month (>80%). In addition, the intervention group reported increased PA (odds ratio [OR] = 4.4, P < .001), increased conceptual knowledge in five domains (OR = 2.6–4.2, all P < .05), and altered disease management strategies (e.g., increased PA) (OR ≥ 2.7 P < .05) in comparison to the control group. The latter was also different between groups at 12 months (OR = 3.7, P = .044). Knowledge of PA was correlated with level of PA ( ρ = .425–.512, P < .05) as well as to the use of PA as a strategy to manage their disease ( χ 2 = 11.2–32.9, P < .05). Conclusion: Giving patients with COPD access to the COPD Web in addition to their ordinary primary care might be an effective shorter term (3 month) strategy to promote self-management. However, these results needs to be confirmed in a definitive large-scale trial. Key points Even though self-management strategies are an important part of chronic obstructive pulmonary disease (COPD) management, access to support for such strategies are limited for a large part of the COPD-population. Promoting self-management through the COPD Web might increase short-term levels of physical activity, promote conceptual knowledge and alter disease management strategies. The primary care COPD population in this study experienced limited impact of the disease in daily life, limited exertional dyspnea, and high generic quality-of-life, but vastly reduced levels of physical activity. A future large scale study should include strategies to encourage gr...

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

Cited by 32 publications

References 42 publications

Perceptions of Home Telemonitoring Use Among Patients With Chronic Obstructive Pulmonary Disease: Qualitative Study

Perceptions of Home Telemonitoring Use Among Patients With Chronic Obstructive Pulmonary Disease: Qualitative Study

Sociodemographic Factors Influencing the Use of eHealth in People with Chronic Diseases

Can the COPD web be used to promote self-management in patients with COPD in swedish primary care: a controlled pragmatic pilot trial with 3 month- and 12 month follow-up

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