R. van der Vaart

Experiences and Preferences of Patients with Rheumatic Diseases Regarding an Interactive Health Communication Application

Objective Interactive Health Communication Applications (IHCAs) can make a valuable contribution to rheumatological care. The development of online health applications is moving quickly, and positive results have been shown. Yet solid research on use and acceptance of different information, communication and participation tools by patients is still lacking. In this qualitative study, we examined the health-related internet use of patients with rheumatic diseases, their motives for using or not using certain applications, and their needs and preferences with regard to a rheumatology IHCA. Method Semi-structured individual interviews were conducted with eighteen patients, who were selected from a hospital’s patient panel. Participants were diagnosed with eight different forms of rheumatism and their mean age was 50.7 years. The interviews were coded by two independent researchers. Results The applications most preferred by participants were: information provision on both medical and support topics, online communication with their doctor and insight in their personal health records. Patient support groups were less valued as were participation tools such as symptom monitoring and online exercise programs. Furthermore, a large discrepancy was shown between patients’ current use and their future preferences with respect to information about care and support, access to personal health records and having online contact with their doctor. Conclusion Patients see great value in an IHCA provided by their own hospital, since it could increase reliability, and would give them the confidence to use the application. The current study shows a significant discrepancy between current use and future preferences rheumatism patients have regarding online communication with their doctor, online symptom monitoring and insight in their personal health record. Overall a rheumatology IHCA should contain communication and participation tools, both linked to the hospital, and information about disease, care and practical support. Since this study focused on the communication with patients regarding a technological ehealth system which will include information, communication and participation, this paper is relevant on the conference topics eHealth systems and communcations, eHealth technology and devices and Telemedicine/ehealth applications.

Preparation of a MFI zeolite coating on activated carbon

A new and simple method for the preparation of MFI zeolite coated activated carbon is presented. Suitable nucleation sites for the growth of zeolites were introduced to the carbon by adding hydrophilic montmorillonite clay to the carbon substrate. A gas tight MFI zeolite coating was obtained on this modified substrate by hydrothermal growth.

Development and evaluation of a hospital-based web portal with patient access to electronic medical records

Objective Using a user-centered approach, a hospital-based Web portal was developed which provides rheumatology patients with information and access to their electronic medical records (EMR). In this presentation the developmental phases of the Web portal will be shortly explained and, subsequently, the evaluation results will be discussed. In the evaluation, the use, satisfaction and impact on empowerment of the web portal was assessed among patients with rheumatoid arthritis. Methods To evaluate the web portal, a pretest-posttest study among 360 patients was conducted. Questionnaires assessed patients’ socio-demographics, health literacy, Internet use, disease characteristics, and “empowerment” before and after launching a hospital-based web portal. To measure empowerment, patients’ satisfaction with care, trust in their rheumatologist, self-efficacy in patient-provider communication, illness perceptions, and medication adherence were assessed. The post-test included questions on web portal use, satisfaction, and self-perceived impact due to web portal use. Results 54% of respondents with Internet access had viewed their EMR. Respondents were positive about the ease of use and usefulness of the portal and reported very few problems. Age (P=.03), amount of Internet use (P=.01) and self-perceived Internet skills (P=.03) significantly predicted web portal use. Of the respondents who had logged in, 44% reported to feel more involved in their treatment and 37% felt they had more knowledge about their treatment. Significant differences over time were not found on the used instruments. Conclusion The current portal succeeded to offer patients access to their EMR in a usable and understandable way. While its impact is difficult to grasp, an evident part of patients feels more empowered due to the web portal. Offering patients home EMR access seems to be a valuable addition to the care process, with the potential to involve patients more in their own treatment. Disclosure of Interest None Declared

Health-related Internet use by patients: Reply to Ortego-Centeno N. et al

We read with interest the article by van der Vaart et al published recently in Arthritis Care & Research (1) describing the information needs and support of patients with systemic sclerosis. This article partially recapitulated the results and conclusion made by us in a related study (2). Our study included 184 patients from different Spanish regions and with different autoimmune diseases, including systemic sclerosis (17.1%). Internet use for healthrelated purposes was similar among all studied patients, regardless of the pathology. The mean SD age was 47.5 15.04 years, from which 72.8% were women. In total, 84% of subjects had searched the internet for information relating to their condition, a percentage similar to that reported by van der Vaart et al (1). The variables associated with internet use to find health information were age 56 years (odds ratio [OR] 5 [95% confidence interval (95% CI) 2.5–9.9], P 0.000), being a regular internet user (OR 12.9 [95% CI 5.9–28.2], P 0.000), having a college education (OR 5.5 [95% CI 2.9–13.8], P 0.000), dissatisfaction with the information received by the regular doctor (OR 3.4 [95% CI 1.5–7.5], P 0.003), and belonging to a patient’s association (OR 1.9 [95% CI 1–3.6], P 0.05). In our study, 20.7% of the patients thought information found on the internet was of limited use or of no use at all, and 31% did not know of any website with quality or accurate information about their disease. Van der Vaart et al did not evaluate the usefulness of the information found on the internet. It is well-known that the validity of some health-related websites is questionable, and there are no laws or regulations governing the accuracy of the information on the internet (3). Quality varies widely in the field of rheumatic diseases, and URLs with the .gov and .edu suffixes are generally better (4). Furthermore, many patients experience difficulties when interpreting the information and distinguishing between good and bad information (5). More than half of the patients (66.8%) wanted their physicians to inform them on quality websites. Similarly to van der Vaart et al (1), we consider it essential that physicians participate actively in the development of quality websites to ensure that patients have accurate information as well as to promote the development of interactive health communication applications as a tool for a better followup of our patients. Better-informed patients will be more adherent to the treatments prescribed by their physicians (6,7).