Exploring the barriers and facilitators for the use of digital health technologies for the management of COPD: a qualitative study of clinician perceptions

Abstract

Background Digital health technology (DHT) promises to support patients and healthcare professionals (HCPs) to optimize the management of chronic obstructive pulmonary disease (COPD). However, there is a lack of evidence demonstrating the effectiveness of DHT for the management of COPD. One reason for this is the lack of user-involvement in the development of DHT interventions in COPD meaning their needs and preferences are rarely accounted for in the design phase. Although HCP adoption issues have been identified in relation to DHT, little is known about the challenges perceived by HCPs providing care to COPD patients. Therefore, this study aims to qualitatively explore the barriers and facilitators HCPs perceive for the use of DHT in the management of COPD. Methods Participants (n = 32) were recruited using snowball sampling from two university hospitals and several general practitioner clinics. A semi-structured interview was conducted with each participant. NVivo 12 software was used to complete thematic analysis on the data. Results Themes identified include: data quality; evidence-based care; resource constraints; and digital literacy presented as barriers; and facilitators include the following themes: digital health training and education; improving HCP digital literacy; and Personalized prescribing. Patient-centered approaches, such as pulmonary rehabilitation and shared decision-making were suggested as implementation strategies to ease the adoption of digital health for the management of COPD. Conclusion These findings contribute new insights about the needs and preferences of HCPs working in COPD regarding DHT. The findings can be used to help mitigate user-experience issues by informing the design of person-centered implementation and adoption strategies for future digital health interventions in COPD.

Barriers and Facilitators to the Adoption of Mobile Health Among Health Care Professionals From the United Kingdom: Discrete Choice Experiment

“…A 2019 study of Irish chronic obstructive pulmonary disorder specialists found a need for a strong evidence before considering the adaptation digital health technology in clinical practice, with published studies seen as a surrogate for safety [ 14 ], whereas findings similar to that from this study were observed among Dutch dermatologists [ 10 ], Norwegian GPs [ 15 ], and Belgian family physicians [ 17 ]. The same was observed in this study.…”

“…Although the rollout of e-services including the electronic prescription service (EPS) has widely been a success, with 93% of England’s 7300 general practitioner (GP) practices enrolled and more than 67% of prescriptions delivered via EPS [ 7 ], clinical engagement with digital health technologies, despite a suggested appetite for digital health [ 8 - 10 ], is to date minimal [ 11 , 12 ]. A survey of nurses in Catalonia demonstrated that only 6.5% of those included frequently recommended digital technologies as part of routine patient care [ 11 ], with similar studies in France [ 13 ], Ireland [ 14 ], Norway [ 15 ], Germany [ 16 ], Belgium [ 17 ], and Australia [ 18 ] also highlighting a hesitance among health professionals to engage with and recommend digital health technologies in routine practice.…”

Feasibility of an online platform delivery of pulmonary rehabilitation for individuals with chronic respiratory disease

“…In fact, online-PR delivery has been reported as a solution to enabling improved patient digital health skills, by incorporating such information in education sessions. 22 Furthermore, a previous pilot of home-based online-PR suggests that such platforms are useable by participants and economically viable. 23 …”

Building the Digital Mental Health Ecosystem: Opportunities and Challenges for Mobile Health Innovators

“…Importantly, presenting efficacy data and privacy matters in clear terms is essential to engage providers in the uptake of novel digital tools. In other areas of medicine, a clear evidence base, ease of use, and swift integration into clinical workflows have proven to facilitate the uptake of digital health technologies [ 39 , 40 ]. Experts have suggested that the introduction of novel technologies in health care could be facilitated by a dedicated health care profession called a “digital navigator,” whose task in hospitals and clinics would be to select evidence-based apps, troubleshoot, and interpret digital data outputs in a clinically meaningful way [ 41 ].…”