From the The Insight Centre for Data Analytics, University College Dublin, Dublin, Ireland.
Tallaght University Hospital, Dublin, Ireland.
QJM. 2020 Mar 1;113(3):163-172. doi: 10.1093/qjmed/hcz241.
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.
背景:数字健康技术(DHT)有望支持患者和医疗保健专业人员(HCP)优化慢性阻塞性肺疾病(COPD)的管理。然而,目前缺乏证据表明 DHT 对 COPD 管理的有效性。造成这种情况的一个原因是在 COPD 中开发 DHT 干预措施时缺乏用户参与,这意味着他们的需求和偏好很少在设计阶段得到考虑。尽管已经确定了与 DHT 相关的 HCP 采用问题,但对于为 COPD 患者提供护理的 HCP 所感知的挑战知之甚少。因此,本研究旨在定性探讨 HCP 认为在 COPD 管理中使用 DHT 的障碍和促进因素。
方法:使用滚雪球抽样法从两所大学医院和几家全科医生诊所招募了 32 名参与者。对每位参与者进行半结构化访谈。使用 NVivo 12 软件对数据进行主题分析。
结果:确定的主题包括:数据质量;循证护理;资源限制;数字素养被视为障碍;促进因素包括以下主题:数字健康培训和教育;提高 HCP 的数字素养;和个性化处方。以患者为中心的方法,如肺康复和共同决策,被建议作为实施策略,以缓解 COPD 管理中数字健康的采用。
结论:这些发现为 COPD 中工作的 HCP 对 DHT 的需求和偏好提供了新的见解。这些发现可以通过告知 COPD 中未来数字健康干预措施的以患者为中心的实施和采用策略的设计,帮助减轻用户体验问题。
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