A website to improve asthma care by suggesting patient questions for physicians: qualitative analysis of user experiences.
BACKGROUND
Asthma is one of the most prevalent chronic conditions in the United States, yet despite the existence of national guidelines, nearly three fourths of patients with asthma do not have adequate control and clinical adherence to guidelines is low. While there are many reasons for this, physician inertia with respect to treatment change is partly to blame. Research suggests that patients who ask for specific tests and treatments are more likely to receive them.


OBJECTIVE
This study investigated the impact and experience of using an interactive patient website designed to give patients individual feedback about their condition and to suggest tailored questions for patients to ask their physician. The website was designed to be used prior to a physician visit, to increase the likelihood that patients would receive recommended tests and treatments.


METHODS
A total of 37 adult patients with asthma participated in semi-structured telephone interviews aimed at eliciting information about their experiences with the website. Transcripts were coded using qualitative data analysis techniques and software. Themes were developed from subsets of codes generated through the analysis. In addition, 26 physicians were surveyed regarding their impressions of the website.


RESULTS
Opportunities exist for improving website feedback, although the majority of both patient and physician respondents held favorable opinions about the site. Two major themes emerged regarding patients' experiences with the website. First, many patients who used the website had a positive shift in their attitudes regarding interactions with their physicians. Second, use of the website prompted patients to become more actively involved in their asthma care. No patient reported any negative experiences as a result of using the website. Physicians rated the website positively.


CONCLUSIONS
Patients perceived that the interactive website intervention improved communication and interaction with their physicians, suggesting that patients can play a role in overcoming the clinical inertia of providers. Although the design and content of the website can be improved upon, the main findings suggest that use of the website is well accepted and is perceived to improve the quality of care that patients receive.
Hartmann
Christine W
CW
Department of Health Policy, Jefferson Medical College, Philadelphia, PA 19107, USA. cwhrtmnn@aol.com
Sciamanna
Christopher N
CN
Blanch
Danielle C
DC
Mui
Sarah
S
Lawless
Heather
H
Manocchia
Michael
M
Rosen
Rochelle K
RK
Pietropaoli
Anthony
A
D000328:Adult; D001249:Asthma / Q000628:therapy*; D001291:Attitude of Health Personnel; D005260:Female; D007722:Health Knowledge, Attitudes, Practice; D006801:Humans; D020407:Internet; D008297:Male; D008875:Middle Aged; D009862:Online Systems / Q000295:instrumentation; D010353:Patient Education as Topic / Q000379:methods; D010358:Patient Participation / Q000379:methods*; D017060:Patient Satisfaction; D010817:Physician-Patient Relations; D036301:Qualitative Research; D011785:Quality Assurance, Health Care / Q000379:methods; D014481:United States