Understanding the barriers experienced by older adults using mobile health tools highlights key areas for improvement and research efforts in telehealth.
While older adults with asthma and chronic obstructive pulmonary disease (COPD) see positives of mobile health (mHealth) tools, they also expressed apprehension about changes to their health care experiences.
In a new study published in the Journal of Medical Internet Research, researchers gained a greater understanding of patient perspectives and experiences for this population, highlighting key areas to guide researchers towards potential strategies to improve health technology use in this demographic of patients who need greater care.
To the researchers’ knowledge, this study is the first of its kind to qualitatively investigate mHealth use in older patients with asthma and COPD.
“In this study, we explored mHealth-related perceptions and experiences of older adults with asthma and COPD,” wrote the researchers of the study. “Overall, their experiences were reflected in a tension between the perception that mHealth [mobile health] could be used to help maintain independence and an apprehension of ways that mHealth might negatively change established health care experiences.”
The study included semi-structured interviews of patients ages 65 years and older with asthma or COPD who also owned a smartphone. Using phenomenological methodology, the researchers analyzed the interview transcripts from patients to develop themes and experiences of mHealth use. These qualitative findings were then summarized and proposed as strategies to leverage and implement efforts to improve older adult use of airway mHealth tools.
A total of 35 patients were identified, in which 20 agreed to be interviewed. However, 5 of these patients did not own a smartphone and the remaining 10 did not return messages. By the 17th interview, the researchers had attained data saturation, but completed 3 additional interviews to determine that no new themes were developed.
Because these interviews were conducted at the time of the COVID-19 pandemic between March 2021, and March 2022, all interviews were held virtually. Interviews were about 40 to 60 minutes long and were transcribed verbatim from audio recordings. Interview questions included broad, open-ended questions pertaining to the patient’s previous experience with mHealth, how age influenced their perspectives of mHealth, and their general experiences with mobile technology.
Of the patients included in the study, the mean (SD) age was 79.8 years (4.4 years). Most patients used controller inhalers with infrequent reliver use, were university or college educated, and lived in urban areas. Additionally, most patients owned both a smartphone and tablet, which they used daily to search the internet for asthma and COPD information, such as symptoms, medications information, breathing exercises, and treatment options.
Themes described by these patients showed a conflict between the perception that mHealth could help maintain independence throughout aging, as well as caution towards the ways in which mHealth could negatively affect established health care experiences. These themes were absent from previous research that focused on younger adults with asthma and COPD.
The researchers acknowledged some limitations to the study, such as requiring the participant to own a smartphone, which may have led to a biased subset of older patients who were more digitally engaged. Additionally, because the study was predominantly comprised of urban living and higher educated individuals, the study ignored the cultural and socioeconomic barriers of digital health equity.
Despite these limitations, the researchers believe the study can be applicable to future telehealth research, in which addressing these themes has the potential to improve the implementation of mHealth tools among a growing number of older adults with airway diseases.
“With these shifting demographics, a growing number of older adults will be living with asthma and COPD, and mHealth innovations have the potential to help older patients to more effectively manage their chronic respiratory disease,” wrote the researchers of the study. “We found that a greater understanding of the perspectives and experiences of older adults with asthma and COPD in their use of mHealth provides valuable insights into how we might further improve and expand its reach.”
Kouri A, Gupta S, Straus SE, Sale JEM. Exploring the Perspectives and Experiences of Older Adults With Asthma and Chronic Obstructive Pulmonary Disease Toward Mobile Health: Qualitative Study. J Med Internet Res. Published online, 2023 August 22. doi:10.2196/45955