title: Internet access and use by COPD patients in the National Emphysema/COPD Association Survey.
abstract: BACKGROUND
  Technology offers opportunities to improve healthcare, but little is known about Internet use by COPD patients. We tested two hypotheses: Internet access is associated with socio-demographic disparities and frequency of use is related to perceived needs.
  
  
  METHODS
  We analyzed data from a 2007-2008 national convenience sample survey of COPD patients to determine the relationship between Internet access and frequency of use with demographics, socio-economic status, COPD severity, and satisfaction with healthcare.
  
  
  RESULTS
  Among survey respondents (response rate 7.2%; n = 914, 59.1% women, mean age 71.2 years), 34.2% reported lack of Internet access, and an additional 49% had access but used the Internet less than weekly. Multivariate models showed association between lack of access and older age (OR 1.10, 95% CI 1.07, 1.13), lower income (income below $30,000 OR 2.47, 95% CI 1.63, 3.73), less education (high school highest attainment OR 2.30, 95% CI 1.54, 3.45), comorbid arthritis or mobility-related disease (OR 1.56, 95% CI 1.05, 2.34). More frequent use (at least weekly) was associated with younger age (OR 0.95, 95% CI 0.93, 0.98), absence of cardiovascular disease (OR 0.48, 95% CI 0.29, 0.78), but with perception of needs insufficiently met by the healthcare system, including diagnostic delay (OR 1.72, 95% CI 1.06, 2.78), feeling treated poorly (OR 2.46, 95% CI 1.15, 5.24), insufficient physician time (OR 2.29, 95% CI 1.02, 5.13), and feeling their physician did not listen (OR 3.14, 95% CI 1.42, 6.95).
  
  
  CONCLUSIONS
  An analysis of the characteristics associated with Internet access and use among COPD patients identified two different patient populations. Lack of Internet access was a marker of socioeconomic disparity and mobility-associated diseases, while frequent Internet use was associated with less somatic disease but dissatisfaction with care.
authors.affiliation: Division of Pulmonary and Critical Care, University of Michigan Health System, 3916 Tubman Center, 1500 E, Medical Center Drive, Box 0360, Ann Arbor, USA. carlosma@med.umich.edu.
authors.forename: Carlos H
authors.initials: CH
authors.lastname: Martinez
authors.forename: Beth L
authors.initials: BL
authors.lastname: St Jean
authors.forename: Craig A
authors.initials: CA
authors.lastname: Plauschinat
authors.forename: Barbara
authors.initials: B
authors.lastname: Rogers
authors.forename: Julen
authors.initials: J
authors.lastname: Beresford
authors.forename: Fernando J
authors.initials: FJ
authors.lastname: Martinez
authors.forename: Caroline R
authors.initials: CR
authors.lastname: Richardson
authors.forename: Meilan K
authors.initials: MK
authors.lastname: Han
mesh_terms: D000368:Aged; D005260:Female; D006801:Humans; D057226:Information Seeking Behavior; D020407:Internet / Q000706:statistics & numerical data*; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D029424:Pulmonary Disease, Chronic Obstructive / Q000628:therapy; D011795:Surveys and Questionnaires
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