qLessons learned from patients with access to an online self-management enhancing program for RA patients: Qualitative analysis of interviews alongside a randomized clinical trial

• Published in: Patient education and counseling Vol. 102; no. 6; pp. 1170 - 1177
• Main Authors: Zuidema, R.M., Van Dulmen, S., Nijhuis-van der Sanden, M.W.G, Fransen, J., Van Gaal, B.G.I
• Format: Journal Article
• Language: English
• Published: Ireland Elsevier B.V 01.06.2019
• Subjects: Adult; Aged; Arthritis, Rheumatoid - therapy; Computer-Assisted Instruction; Female; Humans; Interviews as Topic; Male; Middle Aged; Motivation; Nursing; Patient Education as Topic; Qualitative Research; Self-Management
• ISSN: 0738-3991; 1873-5134
• DOI: 10.1016/j.pec.2019.01.005

•Patients’ motivation combined with unclear expectations explained the low usage of the online program.•Reminders alone to the patients were not adequate enough to increase the usage of the online program. It is recommended.•That health professionals have an essential role in supporting patients to use an online program.•To conduct an individual needs assessment to tailor the program to patients’ needs.•To integrate this program in the standard care. This study aims to explain the earlier findings of a Randomized Controlled Trial (RCT), which showed that rheumatoid arthritis (RA) patients did not benefit from an online self-management program. Moreover, less patients than expected used the program. As part of an explorative RCT, patients were interviewed to explore their (non) usage of the program. Purposive sampling (n = 21) was used to select patients from four groups of patients (n = 49): 1) non-users; 2) low users; 3) high users basic; 4) high users plus. The program supported only a small group of patients because: 1) not all patients were motivated to use the program, 2) patients had no clear expectation or had differing expectations of the program, 3) there was a mismatch between individual patients’ support needs and the needs included in the program, 4) reminders were only sent to fill in the diaries for pain and fatigue, not to use the program modules. This study offers insights in the (non-) usage of online programs and how usage could be increased in practice. Health professionals should be involved in the implementation of this online programs and should inform patients what the program could bring them.