Telemonitoring in COPD: a qualitative study of patients´ needs and requirements

Background
Telemonitoring (TM) is being integrated into treatment to enhance patients’ health skills. However, research is needed to understand the significance of patients’ individual resources and their social context in relation to TM. Therefore, we examined the views of patients with Chronic Obstructive Pulmonary Disease (COPD) and healthcare professionals’ (HCPs) on the Danish TM solution, TeleCOPD, its role in developing health skills.
Methods
We conducted a qualitative interview study comprised of five individual interviews with patients suffering from severe to very severe COPD and two group interviews with nurses and doctors recruited from Lillebælt Hospital in Denmark. A data-driven analysis was performed, followed by an analysis using Bourdieu’s Capital Theory converted into the field of health. Weber’s Ideal types were used as an analytical tool to link individuals’ motivations with their actions, aiming to identify patterns.
Results
Based on the analysis, three distinct patient types were identified: The Health Enthusiast (take charge of their health), The Pragmatic (selective in health practices), and The Disease-oriented (passive health behavior). Each type is distinguished by factors that affect their health capital, behavior, and values. These factors may also partly explain whether they are offered TM and if they desire it.
Conclusion
Our study reveals a discrepancy between the standardized design of TeleCOPD and patients’ need for individualized care. This misalignment may result in some patient opting out of TM or being excluded by HCPs. Contrary to its original purpose, TeleCOPD may increase health inequalities as some patients will presumably not be given access to the solution.