eHealth literacy across remote monitored patients in primary health care: a cross-sectional study

Background

The aim is to increase knowledge in differences in eHealth literacy patterns across patient groups, to gain understanding of its contribution to health inequalities, and adaptation of digital health services. Healthcare is shifting from hospital-based to home-based care, with primary health care (PHC) as the central hub. This shift requires large-scale implementation of new care models, including digital services such as remote patient monitoring (RPM). Pilot projects exist, but large-scale implementation remains limited. Further research on RPM in PHC for sustainable chronic disease management is needed.

Methods

This study is part of the EU co-funded project CIRCE-JA, where a Spanish RPM care model is being transferred and implemented into Swedish PHC. This descriptive cross-sectional study included PHC patients in northern Sweden (≥18 years) with heart failure, hypertension, or type 2 diabetes with RPM for ≥4 months. Demographic data were analyzed descriptively. eHealth literacy was assessed using the 35-item eHealth Literacy Questionnaire (eHLQ), comprising seven domains. Internal consistency was evaluated with Cronbach’s alpha. Differences by education and age were analyzed using ANOVA with Games Howell post hoc tests, sex and language differences using Mann–Whitney U test.

Results

Data have been collected from 135 patients in PHC, age-groups between 26 to > 90, 44 percent were women. The eHLQ demonstrated good internal consistency across the seven domains (α 0,81–0,92). The preliminary results indicate differences in eHealth literacy between age-groups, education level and language among remote monitored patients. No differences between men and women were identified.

Conclusions

Digital health solutions should be tailored to characteristics and the needs of the target populations. Information, education, and support must be adaptable to optimize effectiveness of remote care interventions.

Key messages

• eHealth literacy needs to be considered when developing and implementing digital health solutions. Information, education, and support must be adaptable to optimize digital care interventions.

• Patient remote monitoring can increase the accessibility, safety, quality, and efficiency of healthcare, lower costs and decrease care consumption. However, eHealth literacy can affect the outcome.