JMIR Publications

ABSTRACT

Background:

Patients' empowerment is a main point of health systems’ agenda, means increasing self-disease management, participation in health decisions and promotion of patient-driven studies. But there is also growing evidence that many patients and caregivers innovate by developing new solutions to cope with their health disorders. This activity might increase and improve health solutions’ availability, decrease costs in healthcare, increasing well-being and social welfare. However, our previous research showed low diffusion of these innovations. Therefore, we created an online platform, Patient-innovation.com, where patients, informal caregivers, and collaborators share their innovations. Online social platforms can create virtual communities and have a major role in increasing awareness, giving information and influencing individuals. A quieter and poorer studied phenomenon is the peer-to-peer adoption of user innovations.

Objective:

To study both the development and peer-to-peer adoption of user innovations in healthcare and analyze inherent factors.

Methods:

Using large data from a random and representative sample of adult residents in Portugal (N=6204), we explored characteristics of three groups of individuals and analyzed group differences: i) the developers of health-related solutions for own use (developers), ii) the adopters of solutions developed by other patients or caregivers (peer-to-peer adopters) and iii) the rest of the population. We also studied “intention to adopt” in this last group, its grade and drivers associated.

Results:

In our population, 1.3% were developers and 4.2% peer-to-peer adopters. Women are less likely to develop a solution for own use (OR: 0.30, CI 95% 0.14-0.64). Education is positively associated with the development activity (OR: 1.16, CI 95% 1.03-1.30), the developers are more likely to be unemployed than employed (OR: 5.66, CI 95% 2.05-15.64) and more likely to have face-to-face interactions with other patients or caregivers (OR: 6.90, CI 95% 2.92-16.32). Being a developer or adopter of a solution is positively associated with the depth of search for health solutions (OR: 1.06, CI 95% 1.01-1.12 and OR: 1.05, CI 1.01-1.08, respectively) and peer-to-peer adopters reported less trust in medical science (OR: 0.78, CI 95% 0.61-1.00). Considering the third group of citizens, intentions to adopt patient-developed solutions are negatively associated with age (OR: 0.96, CI 95% 0.95-0.98), positively related to education level (OR: 1.08, CI 95% 1.02-1.15), positively associated with social interactions with other patients and caregivers (OR: 2.84, CI 95% 1.66-4.89) and, negatively associated with the trust in physicians (OR: 0.75, CI 95% 0.62-0.90).

Conclusions:

Our study demonstrated that user innovation and peer-to-peer adoption in healthcare are active phenomena and are significantly associated with high education level and with male gender. Developers and peer-to-peer adopters reported a high level of depth search for health solutions and low trust in science.