Nutzung und Adhärenz digitaler Angebote durch Patienten und Ärzte – unter Berücksichtigung des Alters

ZUSAMMENFASSUNG

Die Digitalisierung des deutschen Gesundheitswesens schreitet stetig voran. Vielfältige digitale Gesundheitsangebote stehen dabei für verschiedene Indikationen und immer mehr Gruppen an Nutzer*innen zur Verfügung. Vermehrt wird sich daher mit der Adhärenz bei solchen digitalen Technologien auseinandergesetzt, die man als effektive Nutzung einer digitalen Anwendung oder Technologie gemäß den Vorgaben und Anleitungen der Hersteller*innen definieren kann. Diese digitale Adhärenz wird von einer Vielzahl an Faktoren beeinflusst. Betrachtet man insbesondere das Alter der Nutzer*innen, so zeigt sich, dass dieser Faktor weder einen generell-negativen noch generell-positiven signifikanten Einfluss auf die Adhärenz hat. Für eine hohe Adhärenz ist es wichtig, dass Entwickler*innen digitale Technologien nutzerorientiert konzipieren und die individuellen Bedürfnisse einzelner Nutzer*innen berücksichtigen. Aktuelle Forschung in der Rheumatologie beschäftigt sich ebenfalls mit digitalen Gesundheitsangeboten, in denen großes Potenzial für eine bessere und effizientere Versorgung liegt, sowie mit der Adhärenz dieser Angebote. Dabei zeigt sich eine große Bereitschaft zur Nutzung digitaler Technologien, unter anderem auch bei älteren Nutzer*innen. Dieser Artikel gibt einen Überblick über Nutzung und Adhärenz digitaler Gesundheitsangebote unter besonderer Berücksichtigung des Alters der Nutzer*innen und betrachtet die Implikationen für die Rheumatologie als Fachbereich.

ABSTRACT

The digitization of the German healthcare system is steadily progressing. A variety of digital health offerings is available for different indications and a growing number of users. The adherence to digital technologies is increasingly being analysed and subject of current discussion. In this context digital adherence can be defined as the effective use of a digital application or technology according to the instructions of the developers. Digital adherence is influenced by a number of different factors. Particularly the age of the users has shown no significant influence on adherence. In order to achieve high adherence it is important that developers configure digital technologies in a user-centric way and under consideration of the individual needs of the users. Current research in the field of rheumatology also addresses digital adherence as well as digital health offerings which possess the potential to ensure a better and more efficient future care. In this context it becomes evident that a widespread willingness to use digital technologies exists – also among older people. This article provides an overview on the use of and adherence to digital health offerings under special consideration of the age of the users. The implications for the field of rheumatology are considered as well.

Schlüsselwörter

Digitale Gesundheitsangebote - digitale Gesundheitsanwendungen - Apps - Digital Health - Technologie-Adhärenz - Adhärenz - Compliance

Keywords

Digital health offerings - digital health applications - apps - digital health - technology adherence - adherence - compliance

Publication History

Article published online:
25 February 2022

• Literatur

• 1 Kolpatzik K, Mohrmann M, Zeeb H. DIGITALE GESUNDHEITSKOMPETENZ in Deutschland 2 2. KomPart 2020
• 2 Tibble H, Flook M, Sheikh A. et al Measuring and reporting treatment adherence: What can we learn by comparing two respiratory conditions?. British journal of clinical pharmacology 2021; 87: 825-836
• 3 Kernebeck S, Busse TS, Ehlers JP. et al Adherence to digital health interventions: definitions, methods, and open questions. Bundesgesundheitsblatt – Gesundheitsforschung – Gesundheitsschutz 2021; 64: 1278-1284
• 4 Mattila E, Lappalainen R, Välkkynen P. et al Usage and Dose Response of a Mobile Acceptance and Commitment Therapy App: Secondary Analysis of the Intervention Arm of a Randomized Controlled Trial. JMIR mHealth and uHealth 2016: 4
• 5 Sieverink F, Kelders SM, Gemert-Pijnen V. Clarifying the Concept of Adherence to eHealth Technology: Systematic Review on When Usage Becomes Adherence. Journal of medical Internet research 2017: 19
• 6 Eysenbach G. The Law of Attrition. J Med Internet Res 2005; 07: 1
• 7 Kelders SM, Kok RN, Ossebaard HC. et al Persuasive System Design Does Matter: A Systematic Review of Adherence to Web-Based Interventions. J Med Internet Res 2012; 14 (06) e152 https://www.jmir.org/2012/6/e152 2012; 14: e2104
• 8 Arsenijevic J, Tummers L, Bosma N. Adherence to Electronic Health Tools Among Vulnerable Groups: Systematic Literature Review and Meta-Analysis. J Med Internet Res 2020; 22 (02) e11613 https://www.jmir.org/2020/2/e11613 2020; 22: e11613
• 9 Beatty L, Binnion C. A Systematic Review of Predictors of, and Reasons for, Adherence to Online Psychological Interventions. International journal of behavioral medicine 2016; 23: 776-794
• 10 Makai P, Perry M, Robben SHM. et al Evaluation of an eHealth intervention in chronic care for frail older people: why adherence is the first target. Journal of medical Internet research 2014: 16
• 11 Mielonen J, Kinnunen UM, Saranto K. et al The Effect of Chronic Diseases on the Use of Health Technology and Digital Services in the Elderly Population in Finland. Studies in health technology and informatics 2020; 275: 147-151
• 12 Linn N, Goetzinger C, Regnaux JP. et al Digital Health Interventions among People Living with Frailty: A Scoping Review. Journal of the American Medical Directors Association 2021; 22: 1802-1812.e21
• 13 Mertens A, Brandl C, Miron-Shatz T. et al A mobile application improves therapy-adherence rates in elderly patients undergoing rehabilitation: A crossover design study comparing documentation via iPad with paper-based control. Medicine 2016: 95
• 14 Becker S, Brandl C, Meister S. et al Demographic and Health Related Data of Users of a Mobile Application to Support Drug Adherence is Associated with Usage Duration and Intensity. PLOS ONE 2015; 10: e0116980
• 15 Meister S, Becker S, Leppert F. et al Digital Health, Mobile Health und Co. – Wertschöpfung durch Digitalisierung und Datenverarbeitung. Digitale Transformation von Dienstleistungen im Gesundheitswesen I 2017: 185-212
• 16 Dekker-van Weering M, Jansen-Kosterink S, Frazer S. et al User Experience, Actual Use, and Effectiveness of an Information Communication Technology-Supported Home Exercise Program for Pre-Frail Older Adults. Frontiers in Medicine 2017; 04: 27
• 17 Nunes A, Limpo T, Castro SL. Acceptance of Mobile Health Applications: Examining Key Determinants and Moderators. Frontiers in Psychology 2019: 10
• 18 Pwa Talboom-Kamp E, Verdijk NA, Kasteleyn MJ. et al High Level of Integration in Integrated Disease Management Leads to Higher Usage in the e-Vita Study: Self-Management of Chronic Obstructive Pulmonary Disease With Web-Based Platforms in a Parallel Cohort Design. J Med Internet Res 2017; 19 (05) e185
• 19 Wiegel J, Seppen B, van der Leeden M. et al Adherence to Telemonitoring by Electronic Patient-Reported Outcome Measures in Patients with Chronic Diseases: A Systematic Review. International journal of environmental research and public health 2021: 18
• 20 Seppen BF, Wiegel J, L’ami MJ. et al Feasibility of Self-Monitoring Rheumatoid Arthritis With a Smartphone App: Results of Two Mixed-Methods Pilot Studies. JMIR Formative Research 2020: 4
• 21 Kiltz U, Kempin R, Richter J. et al Management von Patienten mit axialer Spondylarthritis: Ist die Selbstüberwachung mit einer Smartphone-App machbar? Eine Proof-of-Concept-Studie. In: GMS | Deutscher Rheumatologiekongress 2020, 48. Kongress der Deutschen Gesellschaft für Rheumatologie (DGRh), 34. Jahrestagung der Deutschen Gesellschaft für Orthopädische Rheumatologie (DGORh)
• 22 Grainger R, Townsley H, White B. et al Apps for People With Rheumatoid Arthritis to Monitor Their Disease Activity: A Review of Apps for Best Practice and Quality. JMIR Mhealth Uhealth 2017; 05 (02) e7
• 23 Colls J, Lee YC, Xu C. et al Patient adherence with a smartphone app for patient-reported outcomes in rheumatoid arthritis. Rheumatology 2021; 60 (01) 108-112 10.1093/rheumatology/keaa202, https://pubmed.ncbi.nlm.nih.gov/32572490/, PMID 32572490
• 24 Raghunath S, Hijjawi R, Hoon E. et al Qualitative assessment of medication adherence in patients with rheumatic diseases on biologic therapy. Clinical rheumatology 2019; 38: 2699-2707
• 25 Xiao S, Gaier ED, Mazow ML. et al Improved adherence and treatment outcomes with an engaging, personalized digital therapeutic in amblyopia. Scientific Reports 2020 10:1 2020; 10: 1-8
• 26 Hein A-E, Vrijens B, Hiligsmann M. A Digital Innovation for the Personalized Management of Adherence: Analysis of Strengths, Weaknesses, Opportunities, and Threats. Frontiers in Medical Technology. 2020 0 18
• 27 Lancaster K, Abuzour A, Khaira M. et al The Use and Effects of Electronic Health Tools for Patient Self-Monitoring and Reporting of Outcomes Following Medication Use: Systematic Review. Journal of medical Internet research 2018: 20
• 28 Herrmann M, Boehme P, Hansen A. et al Digital Competencies and Attitudes Toward Digital Adherence Solutions Among Elderly Patients Treated With Novel Anticoagulants: Qualitative Study. Journal of Medical Internet Research 2020: 22
• 29 Seppen BF, Wiegel J, Marike Van Der Leeden. et al Asynchronous mHealth Interventions in Rheumatoid Arthritis: Systematic Scoping Review.
• 30 Richter JG, Nannen C, Chehab G. et al Mobile App-based documentation of patient-reported outcomes — 3-months results from a proof-of-concept study on modern rheumatology patient management. Arthritis Research and Therapy 2021; 23: 1-9
• 31 Kernder A, Morf H, Klemm P. et al Digital rheumatology in the era of COVID-19: results of a national patient and physician survey. RMD Open 2021; 07: e001548