What kind of information and communication technologies do patients with COPD prefer to use? A cross-sectional study in Latin America

Development and evaluation of text messages designed for people with COPD on the mobile pulmonary rehabilitation (m-PR™) platform

OBJECTIVE

To develop and evaluate the ease of understanding and helpfulness of text messages designed to educate, support and motivate people with chronic obstructive pulmonary disease (COPD) as part of an eight-week mobile pulmonary rehabilitation program (m-PR™).

DESIGN, PARTICIPANTS, SETTING AND OUTCOME MEASURES

Text messages were developed in an iterative three stage process: i. development of 85 evidence-based text messages by multidisciplinary health professionals. ii. A survey, including random samples of text messages, was completed by people with COPD who attended a pulmonary rehabilitation assessment at one of five programs in Australia. For each message, participants rated the ease of understanding and helpfulness using a Likert scale and answered an open-ended question seeking feedback. iii. Review of all scores and free text comments informed retention, modification or removal of a text message with the final text messages evaluated for readability.

RESULTS

Eighty-six participants with COPD completed the survey (86/100, 86%; mean (standard deviation) age 72 (9) years; 58% female). Each text message was reviewed by a minimum of five participants. The median score for ease of understanding and helpfulness of text message content was 5 ('strongly agree') and 4 ('agree') respectively. Following review of all text messages, the final bank of 80 text messages had a Flesch-Kincaid Grade level of 6.5 indicating that the messages were fairly easy to read.

CONCLUSION

Most participants with COPD agreed that text messages developed for m-PR™ were easy to understand and helpful. For people with COPD, text messages may educate, support and improve motivation during a pulmonary rehabilitation program. CONTRIBUTION OF PAPER.

Frequency of Use, Perceptions and Barriers of Information and Communication Technologies Among Latin American Physicians: An Ecuadorian Cross-Sectional Study

Objective

In recent years, the use of information and communication technologies (ICTs) has increased in various sectors, among which the healthcare service is no exception. However, studies have mostly focused on the use of ICTs among patients with chronic diseases, with few reports on the advantages and barriers of these technologies among physicians, particularly in Latin America. We designed this study to fill in the gap, as an objective assessment of the frequency of use, perceptions, and barriers of ICTs among physicians remains crucial for a successful implementation of these technologies into the mainstream medical practice.

Methods

We conducted an anonymous cross-sectional survey-based study in 640 Ecuadorian physicians. The survey used consisted of 13 items and evaluated the frequency of use, perceptions, and barriers of ICTs among physicians. Chi-square tests for goodness of fit and independence were performed, whilst Phi coefficient was interpreted to assess the strength of associations. Fisher exact test was performed when required.

Results

Over 90% of physicians reported the use of ICTs to message other colleagues and patients (p=0.000). While 89.5% of physicians used social media to interact with other colleagues, only 58.1% used them to interact with patients (p=0.000). Most participants reported the use of ICTs to search for academic information (p=0.000). Moreover, more than 80.0% agree that ICTs may be used to promote health and medical services, search new job opportunities, get involved in research projects and promote teamwork with colleagues. However, 83.6% of physicians expressed concerns about privacy and patient confidentiality, while 53.8% stated that they lacked the time to use ICTs.

Conclusion

High usage of ICTs was found among Ecuadorian physicians. Younger physicians, with less postgraduate years, and non-specialists were more likely to have a positive perception toward ICTs. Privacy and patient confidentiality, followed by time management, were the most reported barriers in our study.

Impact of Illness on Electronic Health Use (The Seventh Tromsø Study - Part 2): Population-Based Questionnaire Study

Background

Patients who suffer from different diseases may use different electronic health (eHealth) resources. Thus, those who plan eHealth interventions should take into account which eHealth resources are used most frequently by patients that suffer from different diseases.

Objective

The aim of this study was to understand the associations between different groups of chronic diseases and the use of different eHealth resources.

Methods

Data from the seventh survey of the Tromsø Study (Tromsø 7) were analyzed to determine how different diseases influence the use of different eHealth resources. Specifically, the eHealth resources considered were use of apps, search engines, video services, and social media. The analysis contained data from 21,083 participants in the age group older than 40 years. A total of 15,585 (15,585/21,083; 73.92%) participants reported to have suffered some disease, 10,604 (10,604/21,083; 50.29%) participants reported to have used some kind of eHealth resource in the last year, and 7854 (7854/21,083; 37.25%) participants reported to have used some kind of eHealth resource in the last year and suffered (or had suffered) from some kind of specified disease. Logistic regression was used to determine which diseases significantly predicted the use of each eHealth resource.

Results

The use of apps was increased among those individuals that (had) suffered from psychological problems (odds ratio [OR] 1.39, 95% CI 1.23-1.56) and cardiovascular diseases (OR 1.12, 95% CI 1.01-1.24) and those part-time workers that (had) suffered from any of the diseases classified as others (OR 2.08, 95% CI 1.35-3.32). The use of search engines for accessing health information increased among individuals who suffered from psychological problems (OR 1.39, 95% CI 1.25-1.55), cancer (OR 1.26, 95% CI 1.11-1.44), or any of the diseases classified as other diseases (OR 1.27, 95% CI 1.13-1.42). Regarding video services, their use for accessing health information was more likely when the participant was a man (OR 1.31, 95% CI 1.13-1.53), (had) suffered from psychological problems (OR 1.70, 95% CI 1.43-2.01), or (had) suffered from other diseases (OR 1.43, 95% CI 1.20-1.71). The factors associated with an increase in the use of social media for accessing health information were as follows: (had) suffered from psychological problems (OR 1.65, 95% CI 1.42-1.91), working part time (OR 1.35, 95% CI 0.62-2.63), receiving disability benefits (OR 1.42, 95% CI 1.14-1.76), having received an upper secondary school education (OR 1.20, 95% CI 1.03-1.38), being a man with a high household income (OR 1.67, 95% CI 1.07-2.60), suffering from cardiovascular diseases and having a high household income (OR 3.39, 95% CI 1.62-8.16), and suffering from respiratory diseases while being retired (OR 1.95, 95% CI 1.28-2.97).

Conclusions

Our findings show that different diseases are currently associated with the use of different eHealth resources. This knowledge is useful for those who plan eHealth interventions as they can take into account which type of eHealth resource may be used for gaining the attention of the different user groups.

Patients' perspectives on COPD: findings from a social media listening study

We utilised social media listening (SML) to obtain patients' perspectives on symptoms, diagnosis and comorbidities associated with chronic obstructive pulmonary disease (COPD) and its impact on patients' quality of life (QoL). A comprehensive search on social media platforms was performed for English language content posted between July 2016 and January 2018 using COPD-related terms. Social Studio, a social media data aggregator tool, was used to capture relevant records. The content was manually curated to analyse and map psychological aspects with descriptive statistics applied on aggregated findings. A total of 849 posts from patients or caregivers ("patient insights") were considered for the analysis, corresponding to postings of 695 unique individuals. Based on 734 mentions of symptoms from 849 posts by potential patients/caregivers, cough (27%), mucus (25%) and shortness of breath (21%) were the most frequent; analysis by perceived COPD severity indicated these to be common across all severities. Difficulty in mucus clearance (24% of 268 mentions) and sadness (40% of 129 mentions) were top among the aspects impacting physical and emotional QoL, respectively. SML from patients with COPD indicated that relief from cough, mucus production and shortness of breath would be the most desirable aspects of disease management from a patient's perspective.

Preferences of ICT among Patients with Chronic Kidney Disease Undergoing Hemodialysis: An Ecuadorian Cross-Sectional Study

Objectives

The aim of the present study was to assess the frequency of use, and preferences regarding information and communication technologies (ICTs) among Ecuadorian patients with chronic kidney disease (CKD) undergoing hemodialysis.

Methods

We conducted an anonymous cross-sectional survey-based study from January 2016 to April 2017, involving 393 patients with end-stage renal disease from 9 hemodialysis centers, in which they rated their use and preferences of various ICTs through a modified version of the Michigan Questionnaire. The questionnaire collected information regarding demographics, patients' interest in obtaining health-related information through ICTs, and interest in using ICTs as a potential way to communicate with their healthcare providers. A chi-square test for association and adjusted regression analyses were performed.

Results

Among all patients who participated, 64.3% reported owning a cellphone, with less than a third reporting active Internet connection. The most used ICT for obtaining information about CKD and/or hemodialysis was web-based Internet, followed by YouTube. SMS was rated the highest to receive and seek health-related information, followed by Facebook. Younger age and higher levels of education were associated with a higher overall usage of ICTs. Finally, more than half of the patients reported interest in using WhatsApp for communicating with their healthcare providers.

Conclusions

Understanding the preferences of ICTs among patients with CKD undergoing hemodialysis could help to improve their outcomes through the potential uses and benefits of ICTs. Further research is needed to assess their role in improving the care of patients with chronic diseases.