Department of Pulmonology, Franciscus Gasthuis en Vlietland, Kleiweg 500, Rotterdam, 3045 PM, The Netherlands.
Department of Pulmonology, Erasmus Medical Center, Rotterdam, The Netherlands.
Respir Res. 2021 Mar 21;22(1):88. doi: 10.1186/s12931-021-01685-0.
Ehealth platforms, since the outbreak of COVID-19 more important than ever, can support self-management in patients with Chronic Obstructive Pulmonary Disease (COPD). The aim of this observational study is to explore the impact of healthcare professional involvement on the adherence of patients to an eHealth platform. We evaluated the usage of an eHealth platform by patients who used the platform individually compared with patients in a blended setting, where healthcare professionals were involved.
In this observational cohort study, log data from September 2011 until January 2018 were extracted from the eHealth platform Curavista. Patients with COPD who completed at least one Clinical COPD Questionnaire (CCQ) were included for analyses (n = 299). In 57% (n = 171) of the patients, the eHealth platform was used in a blended setting, either in hospital (n = 128) or primary care (n = 29). To compare usage of the platform between patients who used the platform independently or with a healthcare professional, we applied propensity score matching and performed adjusted Poisson regression analysis on CCQ-submission rate.
Using the eHealth platform in a blended setting was associated with a 3.25 higher CCQ-submission rate compared to patients using the eHealth platform independently. Within the blended setting, the CCQ-submission rate was 1.83 higher in the hospital care group than in the primary care group.
It is shown that COPD patients used the platform more frequently in a blended care setting compared to patients who used the eHealth platform independently, adjusted for age, sex and disease burden. Blended care seems essential for adherence to eHealth programs in COPD, which in turn may improve self-management.
自 COVID-19 爆发以来，电子健康平台比以往任何时候都更加重要，能够为慢性阻塞性肺疾病（COPD）患者的自我管理提供支持。本观察性研究旨在探讨医疗专业人员参与对患者使用电子健康平台的依从性的影响。我们评估了单独使用该电子健康平台的患者与混合设置（涉及医疗专业人员）中使用该平台的患者的使用情况。
在这项观察性队列研究中，从 2011 年 9 月至 2018 年 1 月，从电子健康平台 Curavista 中提取了日志数据。纳入至少完成一次临床 COPD 问卷（CCQ）的 COPD 患者进行分析（n=299）。在 57%（n=171）的患者中，电子健康平台在混合环境中使用，其中 128 名在医院，29 名在初级保健机构。为了比较独立使用和在医疗专业人员帮助下使用平台的患者之间的平台使用情况，我们应用倾向评分匹配，并对 CCQ 提交率进行调整后的泊松回归分析。
与独立使用电子健康平台的患者相比，在混合环境中使用电子健康平台与 CCQ 提交率提高 3.25 倍相关。在混合环境中，医院护理组的 CCQ 提交率比初级保健组高 1.83 倍。
与独立使用电子健康平台的患者相比，COPD 患者在混合护理环境中更频繁地使用该平台，调整了年龄、性别和疾病负担等因素。混合护理似乎是 COPD 患者对电子健康计划依从性的关键，这反过来又可能改善自我管理。
