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01.12.2014 | Research article | Ausgabe 1/2014 Open Access

BMC Family Practice 1/2014

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

Zeitschrift:
BMC Family Practice > Ausgabe 1/2014
Autoren:
Viola Voncken-Brewster, Huibert Tange, Albine Moser, Zsolt Nagykaldi, Hein de Vries, Trudy van der Weijden
Wichtige Hinweise

Electronic supplementary material

The online version of this article (doi:10.​1186/​1471-2296-15-4) contains supplementary material, which is available to authorized users.

Competing interests

Hein de Vries is scientific director of Vision2Health, a company that licenses evidence-based innovative computer-tailored health communication tools.

Authors’ contributions

HT, TvdW, HdV and VV designed the study. VV conducted the study and developed the application. HdV, TvdW, AM and HT contributed to the content development and screened the application and AM contributed to the qualitative data collection. VV analyzed the data and AM and ZN were significantly involved in the analysis and interpretation phase. VV drafted the manuscript. All authors were involved in revising the manuscript critically and approved the last version.

Abstract

Background

Changes 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.

Methods

The 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.

Results

Eleven 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.

Conclusion

Results 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.
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