Scripties UMCG - Rijksuniversiteit Groningen
English | Nederlands

‘EHealth, the future of self-management in patients with respiratory diseases and elderly?’A mixed method study among users and professionals

(2018) Verhallen, L. (Lara)

Background: Non-communicable diseases (NCDs) are globally the leading cause of death. Asthma and COPD are NCDs with a high morbidity and mortality. One of the causes for the increase in NCDs is the rapid aging of populations worldwide. Self-management skills can help both elderly and asthma/COPD patients in controlling their chronic conditions. A promising approach to improve self-management is the use of eHealth. Although the potential benefits of eHealth are widely described and the use of eHealth is rapidly growing, realization of these benefits goes rather slow. According to recent scientific publications, reasons for this are that eHealth interventions are not always well adjusted to the patient population and that there are often difficulties with implementation. No clear solutions have yet been found for these problems.
Aim: The aim of this study was to investigate the opinions of asthma/COPD patients and elderly about a self-management application, called the Connecare application, and to investigate the barriers and facilitators of eHealth implementation in health care systems.
Methods: A three-divided study design was performed. First, the opinions of asthma/COPD patients and elderly about the first version of the application were investigated with qualitative semi-structured interviews. Second, barriers and facilitators of eHealth implementation were researched with a quantitative questionnaire among project leaders, managers, healthcare professionals and software developers. Finally, a pragmatic randomized controlled trial will be set up to test the application in asthma/COPD patients and elderly.
Results: Qualitative interviews: Seven elderly and four asthma/COPD patients were interviewed while testing the Connecare application. Both asthma/COPD patients and elderly were positive about the goals of the Connecare application. However, 6/7 of the elderly had problems with the usability of the application. Instruction videos could be helpful to guide users through the application.
Quantitative questionnaire: A total of 55 professionals completed the survey. Most respondents were project leaders (69.8%), with an average age of 40.7 years (SD = 11.3). Overall, participants were satisfied with the development, implementation, maintenance and end result of their eHealth project. A good cooperation between involved parties and the existence of a clear project plan before the development are supposed to be facilitators for a successful eHealth implementation, where the lack of these factors can be barriers. In addition, regular meetings between involved parties tend to be a facilitator and insufficient involvement of the target population tends to be a barrier. Implementation Connecare app: The results of the pRCT are beyond the scope of this thesis due to a delay of the implementation and time limitations. Nevertheless, it is notable that the cooperation between software developers and project leaders and integration of different systems and technological issues were barriers in the implementation. Conclusion: The Connecare application turned out to be not suitable for elderly. Adjustments the application are recommended to make the application usable for all asthma/COPD patients. Furthermore, this study has made a start to explore the barriers and facilitators of the development, implementation and maintenance of eHealth. Further research is needed to make recommendations for the approach in the process of eHealth implementation among these phases.

To top