Perceptions of patients with chronic obstructive pulmonary disease and their health care providers towards using mHealth for self-management of exacerbations: a qualitative study
Open accessAbstract
BACKGROUND: Self-management of exacerbations in COPD patients is important to reduce exacerbation impact. There is a need for more comprehensive and individualized interventions to improve exacerbation-related self-management behavior. The use of mobile health (mHealth) could help to achieve a wide variety of behavioral goals. Understanding of patients and health care providers perspectives towards using mHealth in promoting self-management will greatly enhance the development of solutions with optimal usability and feasibility. Therefore, the aim of this study was to explore perceptions of COPD patients and their health care providers towards using mHealth for self-management of exacerbations. METHODS: A qualitative study using focus group interviews with COPD patients (n = 13) and health care providers (HCPs) (n = 6) was performed to explore perceptions towards using mHealth to support exacerbation-related self-management. Data were analyzed by a thematic analysis. RESULTS: COPD patients and HCPs perceived mostly similar benefits and barriers of using mHealth for exacerbation-related self-management. These perceived benefits and barriers seem to be important drivers in the willingness to use mHealth. Both patients and HCPs strengthen the need for a multi-component and tailored mHealth intervention that improves patients' exacerbation-related self-management by determining their health status and providing adequate information, decision support and feedback on self-management behavior. Most importantly, patients and HCPs considered an mHealth intervention as support to improve self-management and emphasized that it should never replace patients' own feelings nor undermine their own decisions. In addition, the intervention should be complementary to regular contact with HCPs, as personal contact with a HCP was considered to be very important. To optimize engagement with mHealth, patients should have a positive attitude toward using mHealth and an mHealth intervention should be attractive, rewarding and safe. CONCLUSIONS: This study provided insight into perceptions of COPD patients and their HCPs towards using mHealth for self-management of exacerbations. This study points out that future mHealth interventions should focus on developing self-management skills over time by providing adequate information, decision support and feedback on self-management behavior and that mHealth should complement regular care. To optimize engagement, mHealth interventions should be attractive, rewarding, safe and tailored to the patient needs.
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Numerous studies have highlighted the benefits of remote patient monitoring between clinic visits in detecting health deterioration earlier and enabling prompt intervention, particularly for individuals with chronic conditions.
“Numerous studies have highlighted the benefits of remote patient monitoring between clinic visits in detecting health deterioration earlier and enabling prompt intervention, particularly for individuals with chronic conditions [44–50].”
From Caregiver experiences of an integrative patient-centered digital health application for pediatric type 1 diabetes care: Findings from a pilot clinical trial (2025) · cites this paper as [47]
The Results describe earlier recognition of COPD exacerbations as a potential benefit of mHealth symptom monitoring, and the Discussion says participants thought mHealth could encourage prompt health care contact. This qualitative study does not establish that remote patient monitoring achieves earlier detection or prompt intervention across chronic conditions; it also reports clinicians’ concerns about missing signals when monitoring patients at home. Page numbers were not available in our copy. (LLM, conf=0.88)
Experimental — accuracy not yet measuredStudies on remote patient monitoring confirm the importance of HCP involvement with digital tools.
“Studies on remote patient monitoring confirm the importance of HCP involvement with digital tools [44–48].”
From Caregiver experiences of an integrative patient-centered digital health application for pediatric type 1 diabetes care: Findings from a pilot clinical trial (2025) · cites this paper as [47]
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Personalizing Self-Management Interventions in COPD – Looking Beyond One-Size-Fits-All
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“16 Digital COPD applications have the potential to provide better insights into the daily life of an individual COPD patient by using real-time data (eg, symptom data) that can be used for individual risk and benefit profiling, and guide (shared) decision making to provide appropriate personalized…”
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“Furthermore, in line with previous qualitative research [50], the availability of support from healthcare professionals that helped patients to recognize symptoms and subsequently to initiate actions, was indicated by patients as an important facilitator of adherence.”
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Effects of Adherence to an mHealth Tool for Self-Management of COPD Exacerbations
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“28 Educating patients may also facilitate mHealth adoption, whereas technical issues, lack of awareness, and privacy issues can be important barriers.”
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“So I don't want to be thinking about being ill all the time (Korpershoek et al. 2018, 6).”
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“This was similar to the findings of other qualitative studies on the benefits of mHealth for patients with chronic health conditions [37,38].”
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“These challenges may be reinforced by the lack of information provided to participants regarding exacerbations at diagnosis and throughout the COPD care process, which is a known issue in COPD care [25,44].”
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“Activity monitors may also support goal setting, self-monitoring and understanding symptom patterns [8–12].”
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Clinical Provider Perspectives on Remote Spirometry and mHealth for COPD
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Perspective Chapter: Pre-Acceptability in Digital Health Technology
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“At the same time, mHealth should complement regular care (26).”
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“Given the evidence of better healthcare outcomes associated with the effective use of EHR/PHR [42, 43], interventions for PHR use should be advocated for.”
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mHealth Interventions for Self-Management of Chronic Disease
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“[45] argued that providing medical advice and self‑care processes using mobile devices may pose safety risks because of significant variability among patients and their respective symptoms.”
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- Authors
- Korpershoek, Y. J. G., Vervoort, S. C. J. M., Trappenburg, J. C. A., & Schuurmans, M. J.
- Affiliations
- University of Applied Sciences Utrecht (NL)
- University Medical Center Utrecht (NL)
- Corresponding author
- Korpershoek, Y. J. G.
- Venue
- BMC Health Services Research
- Published
- 2018-10-04
- Volume
- 18
- Issue
- 1
- Pages
- 757-757
- ISSN
- 1472-6963 (ISSN-L)
- PMC
- PMC6172846
- OpenAlex
- W2895582407
- Cited by
- 87
- References
- 36
- Citations by year
- 2026: 6 · 2025: 9 · 2024: 10 · 2023: 14 · 2022: 16 · 2021: 14 · 2020: 12 · 2019: 6
- FWCI
- 12.22
- Type
- journal article
- Language
- en
- Open access
- gold
- doi.org
- Licence
- Locations
- BMC Health Services Research (publishedVersion, cc-by)
- Europe PMC (PubMed Central) (publishedVersion, cc-by)
- PubMed Central (publishedVersion, cc-by)
- PubMed (publishedVersion)
- Data Archiving and Networked Services (DANS) (submittedVersion, other-oa)
- DOAJ (DOAJ: Directory of Open Access Journals) (submittedVersion, cc-by-sa)
- Utrecht University Repository (Utrecht University) (submittedVersion, other-oa)
- Funders
- Universiteit van Amsterdam
- Vrije Universiteit Amsterdam
- Topics
- Health Sciences › Health Professions › General Health Professions › Mobile Health and mHealth Applications
- Health Sciences › Medicine › Pulmonary and Respiratory Medicine › Chronic Obstructive Pulmonary Disease (COPD) Research
- Social Sciences › Psychology › Applied Psychology › Digital Mental Health Interventions
- Keywords
- chronic obstructive pulmonary disease, COPD exacerbations, self-management, mobile health, patient perspectives, healthcare provider perceptions, decision support, patient engagement, personalized interventions
- MeSH terms
- Self-Management, Facilities and Services Utilization, Aged, Attitude of Health Personnel, Attitude to Health, Female, Health Personnel, Health Status, Humans, Male, Middle Aged, Perception, Self Care, Focus Groups, Telemedicine, Pulmonary Disease, Chronic Obstructive, Qualitative Research
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