Patients With COPD Prioritize Symptom Control Information Online, Survey Finds

Patients with chronic obstructive pulmonary disease (COPD) still rely on their healthcare providers as the source of primary information about their disease but about a third will bring information from the internet to appointments to discuss, and prioritize information about symptom control, a recent online survey reported.

The research was conducted to understand how patients with COPD perceive web-based health information in order to:

• Determine behaviors of patients with COPD in use of the internet to learn about their disease
• Assess their perspectives regarding 2 educational websites (from the American Lung Association [ALA] and the COPD Foundation)
• See whether patient characteristics, such as older age, severity of breathlessness on the modified Medical Research Council (mMRC), and number of exacerbations in the past year, affected internet health behaviors and assessment of COPD educational websites

Both symptoms and exacerbation history are variables recommended for assessment of patients with COPD in the 2017 report of the Global Initiative for Chronic Obstructive Lung Disease.

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The researchers said improved knowledge about a chronic condition like COPD may help individuals to participate in collaborative self-management with the goal of improving outcomes. Individuals and organizations can use the findings to modify or enhance information about COPD on their websites, the researchers said. Healthcare providers could also use the survey to help recommend educational websites to patients, they said.

Results from the online survey, completed by 445 respondents, found that:

• Physicians were the primary source of information, followed by COPD internet searches.
• COPD health searches focused on 2 areas—specific information about COPD as well as treatments.
• Patients prioritized disease information in order of “symptom control,” “how COPD affects my body,” and “treatments that might work for me”
• Attributes of the ALA website were rated mostly higher than the COPD Foundation website.

In order to participate, respondents were required to have previously searched the internet for health information. Virtually all (99%) graduated from high school; 41% graduated from college.

Ninety-five percent of the respondents reported that they rely heavily on their physician as their primary source of information about COPD. However, the authors noted that available time for discussions in the office may be limited.

Similar to a 2013 Pew Research Center report that found that 72% of adult internet users in the United States sought online health information within the past year, 76% of these respondents indicated that they performed internet searches about COPD.

Patients rated content of both websites as “good” with mean overall ratings of approximately 7 out of 10. These scores suggest that there is an opportunity to improve online materials to achieve higher patients’ ratings. Assessments of specific features indicate that respondents provided higher ratings for all 5 impression attributes and for 8 of 9 content attributes on the ALA website compared with the COPD Foundation website. The identities of the websites were hidden during the survey.

These differences highlight preferences by respondents for COPD health information and how it is delivered. Age, level of breathlessness on the mMRC, and history of exacerbations did not affect patients’ ratings. Whether or not factors such as socioeconomic status, occupation, or severity of disease are associated with patients’ preferences requires further study, the researchers said.

Multiple educational approaches are important in order to provide both interesting and informative content about COPD on the internet, the study said.

Although the respondents were self-selected, their general characteristics were similar to the heterogeneous COPD population based on age, gender (slightly more females), geographical residence (slightly more live in southern United States), most frequently reported symptom (“labored breathing”), severity of shortness of breath, and number of exacerbations in the past year.

The study has several limitations: the respondents required internet access to participate, so findings may not be applicable to patients without a computer or digital literacy; the respondents were viewing sample static screenshots and not navigating live websites; and only 2 organizations were selected for review.

Reference

Mahler DA, Cerasoli F, Della L, Rudzinski M. Internet health behaviors of patients with chronic obstructive pulmonary disease and assessment of two disease websites. Chronic Obstr Pulm Dis. 2018;5(3):158-166. doi:10.15326/jcopdf.5.3.2017.0173.