Evaluation of a Digital Self-management Platform for Patients With Chronic Illness in Primary Care: Qualitative Study of Stakeholders’ Perspectives (Preprint)

Abstract

BACKGROUND Population aging and multimorbidity has led to increasing chronic care needs that are associated with new challenges in managing growing costs, rising healthcare professional workloads, existing paternalistic views, and the adoption of rigorous guidelines. These issues could all benefit from greater digitalization and a more patient-centered approach to chronic care, a situation brought to the fore by the COVID-19 pandemic. Little is known about the real-life use in primary care. OBJECTIVE This study aimed to explore the views, thoughts, usability, and experiences concerning a recently introduced digital self-care platform for chronic conditions in three Dutch primary care practices. METHODS We conducted a explorative study combining questionnaires and interviews among patients and GPs from three general practices that used the digital platform. Questionnaires were sent to patients in each practice to seek the views and experiences of both patient non-users (n = 20) and patient users (n = 58) of the platform, together with standardized questionnaires about illness perception and quality of life. In addition, patients (n = 15) and general practitioners (n = 4) who used the platform took part in semi-structured interviews. We transcribed interviews verbatim and performed qualitative content analysis using a deductive approach. The results of the questionnaires were analysed with descriptive analysis. RESULTS Among patients who had not actively used the platform, but who had received an explanation, only 35% would recommend its use due to concerns over communication and handling. However, this percentage increased to 76% among the people who actively used the platform. The interviews with patients and GPs who used the platform uncovered several key benefits, including reduced time requirements, reduced workload, improved care quality, and improved accessibility due to the greater patient-centeredness and use of different communication tools. In addition, the self-management tool led to greater patient autonomy and empowerment. Although users considered the platform feasible, usable, and easy to use, some technical issues remained and some patients expressed concerns about the reduction in human contact and feedback. CONCLUSIONS the overall experience and usability of the platform was good. Support for the online self-management platform for chronic care increased when patients actively used the tool and could experience or identify important advantages. However, patients still noted several areas for improvement that need to be tackled in future iterations. To ensure benefit in the wider population, we must also evaluate this platform in cohorts with lower digital and health literacy.