Selfmanagement by eHealth in asthma and COPD patients: with or without the professional

Abstract

Introduction: Self-management plays a key role in integrated care strategies. and by definition it suggests a limited role of the professional.

Aims & objective: Myhealthmonitor.eu is an online platform. The asthma / COPD module contains: (1) PROMs (2) Dashboard (3) Knowledge base (4) eConsultation.

Patients join via self-registration or via their HCP (Health Care Professional). Objective is to analyse the behaviour of patients in two settings: (1) with HCP or (2) without HCP.

Methods: 752 patients entered the program after 1-1-2012. Usage of the program was compared between the groups using chi square and t-tests. The association between the number of eConsultations and duration of participation was assessed using linear regression analysis.

Results: 249 patients in the “without HCP” and 503 in the “with HCP” group. Age was similar in both groups.

187 patients (75%) in the “without HCP” group submitted at least one PROMs vs 299 patients (59%) in the “with HCP” group. 2% of patients (both groups) used the knowledge base. In the “with HCP” group 264 patients (52%) used eConsultation (median 1, mean 4,57). The number of eConsultations is predictive for the duration of participation (p<0.001). 351 patients (70%) in the “with HCP” vs 190 patients (77%) in the “without HCP” group were active in some way. In detail: the “with HCP” group was more active (27 vs. 5 actions, p<0.001) and participated longer (mean 325 days vs. 124 days, (p<0.001)).

Discussion: The role of the HCP seems to play a key role to stimulate active and long term participation. Since asthma and COPD are chronic diseases, long term involvement seems crucial. eHealth should be embedded into regular care to be fully effective.