Study Finds Patients With COPD Likely to Use eHealth for Disease Management

Investigators quelled concerns regarding whether patients with chronic obstructive pulmonary disease (COPD) would be likely to use eHealth tools after finding that most had internet access and were regular users of information technology.

People with chronic obstructive pulmonary disease (COPD) may be likely to use COPD eHealth tools, suggesting such tools could be a suitable strategy for helping people with COPD manage their disease, according to a study published in BMC Medical Informatics and Decision Making.

The cross-sectional study from Sweden was the first to use a standardized questionnaire to assess whether individuals with COPD would be able to access and utilize internet-based tools.

eHealth tools can be used to expand access to pulmonary rehabilitation (PR), a standard intervention for patients with COPD that incorporates exercise training, COPD education, and behavioral change strategies. PR has been shown to improve patients’ quality of life, emotional state, physical capacity, and ability to participate in everyday activities while also reducing their mortality risk.

Since the COVID-19 pandemic began, the adoption of digital tools for PR rapidly expanded worldwide. eHealth tools, which consist of using information and communication technologies (ICTs) for improving health, can be delivered using such equipment as a computer, smartphone, tablet, or video conference platform. There is still uncertainty, however, regarding how accessible these tools are and whether the general COPD population has enough knowledge about information technology to use them appropriately.

“In order to reach a larger part of the COPD population, the possibility of using eHealth to a larger extent, both as a supplemental and appropriate way of communicating with participants, will be essential to delivering PR to those in need of it,” the investigators wrote.

The investigators recruited 137 people with COPD, who were older than 40, to participate in telephone interviews utilizing the Statistics Sweden’s 2018 questionnaire on ICT usage. After 17 participants dropped out, 120 participants were included in the analysis. The data were collected from October 2019 to June 2020. The mean age was 72.5 (range, 51-91 years) and 72% were women (n = 86).

Overall, 92% (n = 110) of the participants had internet access, of whom 70% (n = 84) had desktop access and 62% (n = 74) had mobile access. Ninety-one percent reported using the internet in the past 3 months, with 85% (n = 92) of participants identifying as daily users and 82% (n = 89) reporting they used the internet several times a day.

Cellphone or smartphone (89%; n = 96), laptop (68%; n = 74), desktop computer (39%; n = 42), and tablet (46%; n = 50) were the most used devices. Among smartphone users, 94% use applications. Most participants did not have formal training on ICTs. Only 12 had taken a formal course on information technology and 2 participants took paid courses.

Regarding disabilities, 74% (n = 89) of participants reported having a disability, of whom 86% said that their disability did not impact their ability to use a computer or the internet.

The participants rated their probability of using an eHealth tool for COPD management as high, with half having experience using an internet-based support tool for COPD.

The most common requirement for participants was a tool or platform that contained evidence-based and trustworthy general COPD information. They also indicated wanting an eHealth tool that allowed them to communicate with other patients with COPD and health care providers, especially when needing motivation or advice, and to individually adjust programs for exercise training.

Limitations of the study included the inability to evaluate aspects known to decrease internet use, a possible inability to generalize the results to other countries’ COPD populations, and the potential for a selection bias, which was made more likely due to recruiting restrictions for older participants because of the pandemic.

“Future research on adapting an eHealth tool for people with COPD customized for their needs and demands is of great importance,” wrote the investigators.


Sönnerfors P, Roaldsen KS, Ståle A, Wadell K, Halvarsson A. Access to, use, knowledge, and preferences for information technology and technical equipment among people with chronic obstructive pulmonary disease (COPD) in Sweden. A cross-sectional survey study. BMC Med Inform Decis Mak. Published online June 10, 2021. doi:10.1186/s12911-021-01544-4

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