Integrating a tailored e-health self-management application for chronic obstructive pulmonary disease patients into primary care: a pilot study

BMC Family Practice

Research Article

Huibert Tange¹  Viola Voncken-Brewster¹  Trudy van der Weijden¹  Albine Moser²  Hein de Vries³  Zsolt Nagykaldi⁴ 

[1] CAPHRI, Department of Family Medicine, Maastricht University Medical Center, Maastricht, The Netherlands;CAPHRI, Department of Family Medicine, Maastricht University Medical Center, Maastricht, The Netherlands;Centre of Research on Autonomy and Participation of Persons with a Chronic Illness, Faculty of Health and Care, Zuyd University of Applied Sciences, Heerlen, The Netherlands;CAPHRI, Department of Health Promotion, Maastricht University Medical Center, Maastricht, The Netherlands;Department of Family and Preventive Medicine, University of Oklahoma Health Sciences Center, Oklahoma City, USA;

关键词: Chronic obstructive pulmonary disease;    e-Health intervention;    Tailoring;    Self-management;    Smoking cessation;    Physical activity;    Medication adherence;    Primary care;   

DOI  :  10.1186/1471-2296-15-4

 received in 2013-09-24, accepted in 2014-01-06,  发布年份 2014

来源: Springer

【 摘 要 】

BackgroundChanges in reimbursement have been compelling for Dutch primary care practices to apply a disease management approach for patients with chronic obstructive pulmonary disease (COPD). This approach includes individual patient consultations with a practice nurse, who coaches patients in COPD management. The aim of this study was to gauge the feasibility of adding a web-based patient self-management support application, by assessing patients’ self-management, patients’ health status, the impact on the organization of care, and the level of application use and appreciation.MethodsThe study employed a mixed methods design. Six practice nurses recruited COPD patients during a consultation. The e-Health application included a questionnaire that captured information on demographics, self-management related behaviors (smoking cessation, physical activity and medication adherence) and their determinants, and nurse recommendations. The application provided tailored feedback messages to patients and provided the nurse with reports. Data were collected through questionnaires and medical record abstractions at baseline and one year later. Semi-structured interviews with patients and nurses were conducted. Descriptive statistics were calculated for quantitative data and content analysis was used to analyze the qualitative data.ResultsEleven patients, recruited by three nurses, used the application 1 to 7 times (median 4). Most patients thought that the application supported self-management, but their interest diminished after multiple uses. Impact on patients’ health could not be determined due to the small sample size. Nurses reported benefits for the organization of care and made suggestions to optimize the use of the reports.ConclusionResults suggest that it is possible to integrate a web-based COPD self-management application into the current primary care disease management process. The pilot study also revealed opportunities to improve the application and reports, in order to increase technology use and appreciation.

【 授权许可】

CC BY   
© Voncken-Brewster et al.; licensee BioMed Central Ltd. 2014