eHealth tools have been used to educate and monitor patient health and can provide a significant amount of disease-specific information. Despite the wealth of research investigating the effectiveness of eHealth technology, far less is known about user behaviour over time. 

This study, recently published in the Journal of Medical Internet Research was the first to examine the factors that impact the utilisation of eHealth tools targeted at improving of self-management strategies in patients with chronic obstructive pulmonary disease (COPD) over time. Utilisation of self-management strategies have been shown to reduce the need for hospitalisation, increase physical activity and performance, and improve quality of life of patients with COPD. Strategies can include exercise training, breathing strategies, and techniques for conserving energy during daily activities.

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Investigators interviewed 16 consenting patients from 5 publicly funded primary healthcare facilities in Sweden about their experiences in using COPD Web, an eHealth web tool for patients with COPD. They concluded that specific factors, such as experience with technology and health literacy, were key drivers of whether a patient with chronic obstructive pulmonary disease (COPD) would benefit or be likely to use eHealth tools to improve self-management skills.

Study patients were interviewed at 3 months and 7 were interviewed at 12 months, and those considered to be users tended to have a higher level of communicative and critical health literacy than those who were considered nonusers or seldom users.

Any gained benefits from utilising the eHealth tool seemed to be reserved for the users and specifically after 12 months, thus suggesting that eHealth tools can be suitable for supporting COPD-specific self-management skills, although not for everyone or at all times. 

At 12 months, users expressed that they had better insight into their COPD and that they had adopted self-care strategies in their everyday life. They also reported having an easier time using stairs and avoiding minor illnesses that can worsen COPD conditions.

 “Our findings highlight that time might be an essential factor when evaluating the potential benefit of eHealth tools aiming at behavioural changes regarding self-management strategies,” wrote the investigators. 

These novel findings are of importance when designing new eHealth tools as well as when deciding on whether or not an eHealth tool might be appropriate to use if the goal is to support self-management among people with COPD or other conditions.


Marklund S, Tistad M, Lundell S, et al. Experiences and factors affecting usage of an eHealth tool for self-management among people with chronic obstructive pulmonary disease: qualitative studyJ Med Internet Res. April 2021;23(4):e25672. doi:10.2196/25672

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COPD, eHealth, eHealth tools, hospitalisation, LOS, cost, self-management eHealth tools have been used to educate and monitor patient health and can provide a significant amount of disease-specific information. Despite the wealt...