JMIR Publications

ABSTRACT

Background:

The use of eHealth technology to prepare first orthopedic consultations for patients with hip or knee osteoarthritis seems promising. Exploration of data on use and usability of an educational eHealth tool can reveal potential modifications that may increase engagement and effectiveness.

Objective:

1) to identify use and usability of a standalone educational eHealth tool for patients with suspected hip or knee osteoarthritis (OA), 2) to explore if recorded questions in the eHealth tool were in line with an existing widely used question prompt list, and 3) to investigate if user characteristics are related to use and usability.

Methods:

We used data of 144 patients who used the educational eHealth tool to prepare an upcoming first orthopaedic consultation. We defined ‘users’ and ‘non-users’ based on opening the tool at least once or not. ‘Users’ were specified as ‘active’ and ‘passive’. Recorded questions in preparation for the upcoming consultation were categorized into themes fitting 3 predefined questions: ‘What are my options?’, ‘What are the possible benefits and harms of those options?’ and ‘How likely are each of the benefits and harms to happen to me?’, or in a ‘remaining’ category. Usability was measured using the System Usability Scale (SUS, 0-100). We collected data on demographic and clinical characteristics, knowledge on OA, and internet and smartphone usage in daily life. Characteristics associated with ‘users’ and ‘non-users’ were analysed using multivariable logistic regression analysis.

Results:

A total of 116 (81%) participants used the educational eHealth tool, of whom 87 (75%) were ‘active users’. Out of 3 components (‘Information’, ‘My consultation’ and ‘Medication), ‘Medication’ was least used (34%). Based on the recorded questions of users a fourth predefined question could be proposed, i.e. “What is my situation at this moment?”. Mean (SD) SUS score was 64.8 (16.0). No difference was found in SUS scores between superficial and active users (mean difference (95% CI): 0.04 (-7.69, 7.77)). Participants with higher baseline knowledge on OA (OR (95% CI): 1.2 (1.0, 1.4)), who used the internet less frequent in daily life (OR (95% CI): 0.6 (0.5, 0.9)) were more likely to use the educational eHealth tool. We found no differences in demographic and clinical characteristics between superficial and active users.

Conclusions:

Based on the results of this study it can be concluded that the use of an educational eHealth tool to prepare a first orthopedic consultation in patients with hip and knee OA is feasible. Results provide points for improvements to the content of the tool to improve usability. No clear practical implications were found in this study to support implementation of the educational eHealth tool in specific subgroups. Clinical Trial: Dutch Trial Register NTR6262