JMIR Publications

ABSTRACT

Background:

Chronic obstructive pulmonary disease (COPD) is a major health problem and an economic burden globally. There is a growing interest in how electronic health (eHealth) can be used in order to provide efficient health care. Telemonitoring, where the patient’s health-related data is transmitted to a health care provider, can be used to detect early signs of exacerbations. In order to successfully implement telemonitoring systems in clinical practice, it is important to have knowledge about the users preferences.

Objective:

The aim of the study was to explore perceptions on the use of a home telemonitoring system in patients with COPD.

Methods:

Semi-structured individual interviews were carried out with eight women and five men who were participants in a larger project aiming to develop and evaluate a telemonitoring system. The web-based telemonitoring system measured pulmonary function, subjective symptoms and oxygen saturation. Participants were interviewed after having used the system for two to four months. Interview transcripts were analyzed with qualitative content analysis.

Results:

The analysis resulted in the theme “A transition towards increased control and security”, and four categories: using with (in)security, affecting technical concern or confidence, providing easy access to health care, and increasing control over the disease. The participants presented with various perceptions about using the telemonitoring system. They expressed initial feelings of insecurity, both in terms of operating the system and regarding their disease. However, the practical management of the telemonitoring system became easier with time, and they gained increased confidence and improved their self-management. New technology was perceived as an important complement to existing health care, but the importance of maintaining a human contact in real life or through the telemonitoring system was emphasized.

Conclusions:

This study captured a transition among the participants from being insecure and experiencing technical concerns to acquire technical confidence and improve disease management. Telemonitoring can be a valuable complement to health care leading to increased self-knowledge, a sense of security, and improved self-management. However, in order to improve further development and implementation of telemonitoring systems, several actions are needed such as improved patient education and involvement of end users in technical development. Additional research is needed, particularly in the design of user-friendly systems as well as in developing tools to predict which patients are most likely to find the equipment useful as it may result in increased empowerment, reduced costs and suffering, and contribute to equity in health.