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

Abstract

Background Population aging and multimorbidity has led to increasing chronic care needs associated with new challenges in managing growing costs, rising health care professional workloads, 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 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 3 Dutch primary care practices. Methods We conducted an explorative study combining questionnaires and interviews among patients and general practitioners from 3 general practices that used the digital platform. Questionnaires were sent to patients in each practice to seek the views and experiences of both patient nonusers (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 semistructured interviews. We transcribed interviews verbatim and performed qualitative content analysis using a deductive approach. The results of the questionnaires were analyzed with descriptive analysis. Results Among patients who had not actively used the platform but had received an explanation, only 35% (7/20) would recommend its use due to concerns over communication and handling. However, this percentage increased to 76.3% (45/59) among the people who actively used the platform. Interviews with patients and general practitioners 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.

Classifying self‐management clusters of patients with mild cognitive impairment associated with diabetes: A cross‐sectional study

“…Previous studies have shown that self‐management needs to follow the principle of putting the people at the centre and being patient‐oriented in order to improve the efficiency of self‐management and effectively control disease progression (Müller‐Mundt & Schaeffer, 2011; van de Vijver et al., 2022). This study also agrees with this point of view and provides a research basis for setting more personalized self‐management strategies.…”

“…It refers to the internal control of individuals to actively cooperate with medical care providers to cope with disease symptoms. It is considered a key factor affecting disease progression ( Van de Velde et al, 2019). Previous studies have shown that compared with diabetic patients without MCI, patients who suffer from MCI associated with DM have poorer self-management ability (Lai et al, 2018).…”

Identifying unmet needs of dementia caregivers in clinical practice: A user-centered development of a digital assessment (Preprint)

“…The difference between our first digital assessment version compared with the final digital assessment version illustrates the importance of involving multiple perspectives, especially of those for whom the assessment or technology is intended. In the literature, there is an increase of studies involving patients and stakeholders in the development or testing of technology (Hettinga, Boer, Goldberg, & Moelaert, 2009;Øksnebjerg et al, 2020;van de Vijver et al, 2022). The participatory approach allowed us to incorporate aspects into the development of the digital assessment that we, as researchers, would have missed otherwise as can be seen in the first digital tablet-based assessment version in Figure 1 when compared to the final version in Figure 2.…”