JMIR Publications

ABSTRACT

Background:

The need for, and adoption of, eHealth programs is growing worldwide. However, access can be limited among patients from low socioeconomic backgrounds, often resulting in a so-called digital divide due to the mismatch between eHealth and target populations that can gain benefits of critical importance to healthcare, this digital divide can result in unsuccessful eHealth implementations.

Objective:

To evaluate the opinions of elderly patients with asthma and chronic obstructive pulmonary disease (COPD) about an existing pharmacy-based personalized patient web portal (PWP) that provides a medication overview and information about the associated diagnoses.

Methods:

This was a cross-sectional qualitative study of a patient panel of the Groningen Research Institute for Asthma and COPD (GRIAC) in primary care. Participants were required to be older than 55 years, to be Dutch-speaking, to have no prior experience with the study website, and to be diagnosed with a chronic respiratory illness. Two focus groups were created and completed a 45-minute session for testing the website and a 120-minute session for semi-structured interviews. The focus group sessions were recorded, transcribed verbatim, and analyzed by content analysis.

Results:

We enrolled eleven patients (nine women) with a mean age of 66±9 years; of these, five had asthma, three had COPD, two had asthma-COPD overlap syndrome, and one had bronchiectasis. Patients were generally positive about the website, especially the areas providing disease-related information and the medication overview. They also appreciated that the website would enable them to share this information with other healthcare providers. However, some difficulties were reported with navigation, such as opening a new tab, and others reported that the layout of the website was difficult either because of visual impairments or problems with navigation. It was also felt that monitoring would only be relevant if also checked by health care professionals as part of a treatment plan. Patients mentioned few privacy or safety concerns.

Conclusions:

It is feasible to develop websites for elderly patients; however, developers must take the specific needs and limitations of elderly into account (e.g., navigation problems, poor vision or hand-eye coordination). The provision of information appears to be the most important aspect of the website, and as such, we should endeavor to ensure that layouts and navigation remain basic and accessible. Patients are only motivated to use self management applications if they are an integrated part of their treatment. The usability of the website can be improved by including older people during development and by implementing design features designed to improve accessibility in this group. Clinical Trial: 2017.043 (University Medical Center Groningen).