Development of an eHealth programme for self-management of persistent physical symptoms: a qualitative study on user needs in general practice

Mette Trøllund Rask,Pernille Ravn Jakobsen,Jane Clemensen,Lisbeth Frostholm,Marianne Rosendal

doi:10.1186/s12875-021-01380-5

Mette Trøllund Rask, Pernille Ravn Jakobsen + Show 3 more

Open Access

https://doi.org/10.1186/s12875-021-01380-5

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Abstract

BackgroundPersistent physical symptoms (PPS) are estimated to be present in 17% of patients in general practice. Hence, general practitioners (GPs) play a key role in both the diagnostic assessment and the management of PPS. However, research indicates a need to improve their strategies to support self-help in patients, and eHealth tools may serve as an opportunity. This study aimed to explore patients’ and GPs’ needs related to self-management of PPS. The study was designed to inform the future development of eHealth interventions in this field.MethodsThis qualitative study was based on 20 semi-structured interviews (6 GPs and 14 patients with PPS). Interviews were audiotaped, transcribed verbatim and analysed through a five-step thematic analysis approach. First, we conducted an inductive analysis to identify and explore emerging subthemes. Second, using a deductive mapping strategy, we categorised the derived subthemes according to the COM-B behaviour change model and its three domains: capability, opportunity and motivation.ResultsWe identified eleven subthemes in the patient interviews and seven subthemes in the GP interviews. Several unmet needs emerged. First, we identified a need to consider PPS early in the illness trajectory by taking a bio-psycho-social approach. Second, both patients and GPs need better skills to manage uncertainty. Third, hope is important for the patients. Fourth, patients need guidance from their GP in how to self-manage their PPS.ConclusionsThis study provides important insight into key issues and needs related to capability, opportunity and motivation that should be addressed in the design of future eHealth self-management interventions targeting patients with PPS in general practice in order to support and improve care.

Highlights

Two of the General practitioner (GP) took a special interest in physical symptoms (PPS), and a third GP had a special interest in Electronic health (eHealth)/digital solutions
Domain 3: motivation We explored factors important for GPs' motivation to support patients with PPS to self-manage their symptoms through an eHealth programme
In conclusion, several unmet needs emerged from the in-depth interviews with patients with PPS and GPs

Summary

Introduction

Persistent physical symptoms (PPS) are estimated to be present in 17% of patients in general practice. Patients with persistent physical symptoms (PPS), such as pain, dizziness and fatigue, which cannot be attributed to a specific well-defined disease, are frequently seen in general practice and secondary care. PPS are estimated to be present in 10% of adults in the general population according to standardised interviews and in 17% in patients attending general practice according to questionnaire screening [3, 4]. In recent research, this term has been argued to be misleading, and it is unhelpful to patients with PPS [7,8,9]. A recent survey among the general population suggested persistent physical symptoms as the most appropriate and acceptable term [10].

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