Wennemars, J.W. (2013) A patient web portal in a Dutch integrated care service for asthma and COPD: an explorative qualitative study. thesis, Medicine.
![[img]](https://umcg.studenttheses.ub.rug.nl/style/images/fileicons/text.png) |
Text
WennemarsJW.pdf Restricted to Registered users only Download (1MB) |
Abstract
Background: Asthma and COPD are both common lung diseases with a high morbidity. Many patients are underdiagnosed and therefore untreated, while early diagnosis and treatment might improve long-term outcomes. To support general practitioner(GP)s in the diagnosis and management of asthma and COPD, an integrated care service (the Asthma and COPD (A/C) service) was started in 2007. Results are good, with improved control of asthma and COPD and reduced numbers of exacerbations in asthma and COPD. In general, self-management in asthma and COPD patients is low. A large proportion of patients does not use their daily medication as prescribed and 85% of patients have a suboptimal inhalation technique. This leads to more use of health care and increased mortality. The self-management might be improved by giving patients insight in their own medical record through a patient web portal (PWP). A PWP is a secure website which gives online access to personal medical information. The Raad voor de Volksgezondheid en Zorg advised to increase the use of social media to make the health care system more transparent. Furthermore, in 2010 there were already 25 to 40 PWPs in the Netherlands, a number which is increasing. A PWP has many benefits. Diabetic patients who used a PWP had a significant better disease control. In previous studies, patients seemed to be interested. However there are no studies done regarding the opinion of asthma and COPD patients towards a PWP. In this study the opinion of patients and physicians about patient participation in the A/C service through a PWP is examined. Methods: A descriptive and explorative qualitative research design was chosen. Asthma and COPD patients, GPs and pulmonologist(PM)s from a large region in the Northern of the Netherlands were interviewed till saturation was reached. The interviews were held by one interviewer, using a semi-structured interview format. To give participants an impression of a PWP, they were shown examples of webpages. Interviews were audio recorded and transcribed verbatim. Content analysis was done using Kwalitan and Excel. Results: There were seven asthma, eight CODP patients, seven GPs and eight PMs interviewed. Almost everyone was interested in using a PWP. Advantages mentioned were making communication between patients and physicians more accessible, better provision of information and cost-effectiveness. Main advantage mentioned by physicians was better insight in one’s disease, possibly leading to more commitment, self-management and better disease control. Disadvantages were losing personal contact, security issues and patients getting unnecessarily upset. Physicians were also concerned about getting more questions and not reaching the right target group. Finally, participants wondered why the portal would be only for asthma and COPD patients. Most popular features were a medication screen and seeing the medical results. Discussion: The results show that asthma and COPD patients, GPs and PMs have a positive attitude towards a PWP. Two recent study’s among rheumatic patients in a secondary care setting showed similar results. Strengths were the large region from which patients were included and focusing on both the opinions of patients and physicians. Because of the explorative research design, the topics were not examined in depth, which is a disadvantage. This design was chosen to get a broad variety of opinions. Furthermore, there were no patients interviewed participating in the A/C service, however they were all eligible for it. Finally, qualitative analysis was done by one researcher. To conclude: a PWP seems to be a good option for the A/C service, but to make a successful PWP, the precise preferences and wishes of patients and physicians must be further examined. Finally, the possibilities of a PWP for all diseases should be examined.
| Item Type: | Thesis (Thesis) |
|---|---|
| Supervisor name: | Molen, Prof. Dr. T. van der and Metting, E.I. |
| Faculty: | Medical Sciences |
| Date Deposited: | 25 Jun 2020 11:04 |
| Last Modified: | 25 Jun 2020 11:04 |
| URI: | https://umcg.studenttheses.ub.rug.nl/id/eprint/2441 |
Actions (login required)
 |
View Item |