A perspective on web-based information for patients with chronic lung disease

Characterization and reliability of internet resources on pulmonary rehabilitation for individuals with chronic lung disease

BACKGROUND

Individuals with lung disease commonly use the internet as a source of health information on pulmonary rehabilitation (PR). The objective of this study was to characterize internet resources on PR, and to assess the content, readability, and quality of patient-directed PR resources.

METHODS

The first 200 websites for the search term 'pulmonary rehabilitation resources and exercise' were analyzed on Google, Yahoo, and Bing. Website content was assessed based on 30 key components of PR from the 2013 and 2021 international consensus statements. Website quality was determined using DISCERN, JAMA benchmarks, and Global Quality Scale (GQS).

RESULTS

66 unique PR websites were identified with the two most common categories being scientific resources (39%) and foundation/advocacy organizations (33%). The average reading level of websites was 11 ± 3. PR content varied significantly across websites (mean range 13.4-21.5). Median DISCERN total score and GQS score were 4 (IQR 3-4) and 3.5 (IQR 2-4), respectively, representing moderate-good quality. Foundation/advocacy websites had higher DISCERN and GQS scores compared to other websites.

CONCLUSION

Foundation/advocacy websites had the highest quality and reliability metrics; however, the higher-than-recommended reading levels may compromise patient comprehension and utilization. This study provides critical insight on the current state of online PR health-related information.

Communication difficulties reported by patients diagnosed with idiopathic pulmonary fibrosis and their carers: a European focus group study

This paper explores commonalities in the experience and unmet needs of idiopathic pulmonary fibrosis (IPF) patients and carers in Europe throughout the care pathway, focusing specifically on the unmet communication needs of patients and carers. Four patient organisations/groups in Europe held focus groups (Italy (seven patients and four carers); Belgium (six patients); Ireland (23 patients and 10 carers); and England, UK (five patients and three carers)). A focus group schedule was provided and translated into the language of each focus group by the European Lung Foundation (ELF). Content analysis was conducted by the ELF and verified by the authors of the paper. Three main themes emerged: professional-patient, professional-professional and patient-patient communication. Within these themes, eight priority areas were highlighted by two or more of the focus groups. In addition, 17 suggested action points were identified. Patients and carers in Europe have unmet communication needs, which could be met by specialist physicians and specialist centres providing more effective information and signposting to support services, including support groups and patient organisations.

Internet Health Behaviors of Patients with Chronic Obstructive Pulmonary Disease and Assessment of Two Disease Websites

Background: Little is known about patients' use of the internet to search for information about chronic obstructive pulmonary disease (COPD) and their perspectives on disease content on websites. Objectives: To determine the interests and behavior of patients with COPD who search the internet for disease information and to assess their perspectives about 2 COPD educational websites. Methods: Individuals with COPD who had registered for a consumer panel were invited electronically to participate in a survey which included general use of the internet, online health behaviors about COPD, and assessment of 2 COPD educational websites. Results: A total of 445 respondents completed the survey in 23 ± 12 minutes (72% response rate). A total of 95% reported that physicians were the primary source of information about COPD followed by internet searches about the disease (76%). The 3 major information priorities were "symptom control" (82%), "how COPD is affecting my body" (60%), and "treatments that might work better for me" (59%). Overall ratings (range, 1 - 10) were 7.4 ± 1.5 for the American Lung Association and 6.8 ±1.8 for the COPD Foundation websites. Ratings by respondents were higher for all 5 impression attributes and for 8 of 9 content attributes on the American Lung Association website compared with the COPD Foundation website. Conclusions: This report describes, for the first time, information priorities of patients with COPD about their disease and their assessment of 2 educational websites. Our survey results can be used by health care professionals to recommend online resources to their patients.

A web-based educational video to improve asthma knowledge for limited English proficiency Latino caregivers

OBJECTIVES

To evaluate limited English proficiency (LEP) Latino caregiver asthma knowledge after exposure to an educational video designed for this target group.

METHODS

A cross-sectional, interventional study was performed. We aimed to evaluate the post-test impact on asthma knowledge from baseline after exposure to a patient-centered, evidence-based, and professionally produced Spanish asthma educational video. Participants included LEP Latino caregivers of children 2-12 years old with persistent asthma. Enrollment was performed during ED encounters or scheduled through a local community organization. Asthma knowledge was measured with a validated Spanish parental asthma knowledge questionnaire. Differences in mean scores were calculated with a paired t-test.

RESULTS

Twenty caregivers were enrolled. Participants included mothers (100%) from Puerto Rico (75%), with a high-school diploma or higher (85%), with no written asthma action plan (65%), whose child's asthma diagnosis was present for at least 3 years (80%). Mean baseline asthma knowledge scores improved 8 points from 58.4 to 66.4 after watching the educational video (95% CI 5.3-10.7; t(19) = 6.21, p < 0.01). Knowledge improvements were similar across the ED and community groups. Knowledge gains were observed in the areas of ED utilization, medication usage, and activity limitations.

CONCLUSIONS

The developed educational video improved caregiver asthma knowledge for a Latino population facing communication barriers to quality asthma care. Dissemination of this educational resource to LEP caregivers has the potential to improve pediatric asthma care in the United States.

Qualitative European survey of patients with idiopathic pulmonary fibrosis: patients' perspectives of the disease and treatment

Background

‘Living with IPF and an exploration of Esbriet® – a new treatment’ was an exploratory, qualitative, real-world survey of European patients with idiopathic pulmonary fibrosis (IPF) who were receiving treatment with pirfenidone prior to its commercial availability. The aim of the survey was to probe the impact of IPF on patients’ quality of life; the role of healthcare professionals and caregivers; the information needs of both patients and their caregivers; and patients’ perceptions of pirfenidone as a new treatment option for IPF.

Methods

Patients from the UK, Germany and Italy, with a diagnosis of IPF (duration >3 months), who were being treated with pirfenidone, were recruited from patient support groups, specialist centres and advocacy groups. Semi-structured, qualitative, in-depth patient interviews of 1-h duration were conducted by an independent researcher. Patients were initially asked about their experiences of living with IPF and then prompted to describe their experiences of taking pirfenidone. Techniques utilised included: the bubble-speech technique; the icon cards projective exercise; and the free association exercise. All interviews were transcribed and analysed by an independent researcher.

Results

Forty-five patients (71 % male) were interviewed (mean age 68.5 years; mean time since diagnosis 3.5 years); 87 % of patients reported that diagnosis took >1 year. Patients reported that IPF had a significant physical and emotional impact on their quality of life. The beneficial role played by caregivers and interstitial lung disease specialist nurses (where available) was specifically highlighted. Although most patients were keen for information on IPF, this was often of poor quality, out of date, or in English only. Patients’ perceptions of pirfenidone were largely positive and associated with ‘hope’ but were also influenced by the level of side effects experienced.

Conclusions

This survey highlights the impact of IPF on patients’ lives, and the need to adequately support both patients and their caregivers. These findings demonstrate the value of seeking patients’ perspectives of a chronic disease such as IPF and how this information can be used to guide improvements in care, to best support the needs of patients with this devastating condition.

Electronic supplementary material

The online version of this article (doi:10.1186/s12890-016-0171-y) contains supplementary material, which is available to authorized users.