JMIR Publications

ABSTRACT

Background:

A growing segment of the population requires ongoing care and support for managing their chronic diseases. Digital platforms for self-management are rapidly emerging to meet this need, but patients’ experience with these platforms varies significantly. This may be due to the complexity and flexibility of digital platforms, where the wide array of available features can generate unexpected impacts.

Objective:

This study aims to explain how a digital platform can both enable and limit patients suffering from a chronic disease in managing their own health.

Methods:

We conducted semi-structured qualitative interviews with patients to better understand their experience of using a digital platform for self-managing their chronic disease. Patients that had been using a digital platform referred to as the Chronic Care Platform for at least one month were invited to participate. Twenty-four patients were recruited and interviewed in-person or by phone. Collected data were analyzed using template analysis, which is a type of thematic analysis that allows inductive identification of themes from data and deductive application of theory-informed themes. We leveraged Self-Care Theory to understand how patients’ motivations to use the platform and their subsequent use of its features generated perceived value and challenges in achieving this value.

Results:

The platform was shown to support patients’ development of core self-care abilities (cognitive, psychosocial and sociocultural abilities) and self-care behaviours (maintenance, monitoring, management), but did not provide any support to the development of physiological abilities. Moreover, results indicate important limitations in the way in which the digital platform supported all self-care abilities and behaviours, in particular self-care management. Hence, while the platform was viewed as valuable overall, patients reported several challenges in effectively using the Chronic Care Platform for self-care.

Conclusions:

Digital platforms for chronic disease management can enhance patient self-care by providing valuable resources and support for reinforcing desired behaviours. However, gaps in platform features can limit patients’ ability to comprehensively care for themselves. The study shows that relating platform features to specific dimensions of self-care can help to identify missing features, providing a fine-grained understanding of how a given platform is generating positive impacts and how it may be improved to fully support self-care.