Use Of eHealth Research Articles

Barriers and facilitators to the use of e-health by older adults: a scoping review

BackgroundLimited attention has been paid to how and why older adults choose to engage with technology-facilitated health care (e-health), and the factors that impact on this. This scoping review sought to address this gap.MethodsDatabases were searched for papers reporting on the use of e-health services by older adults, defined as being aged 60 years or older, with specific reference to barriers and facilitators to e-health use.Result14 papers were included and synthesised into five thematic categories and related subthemes. Results are discussed with reference to the Unified Theory of Acceptance and Use of Technology2. The most prevalent barriers to e-health engagement were a lack of self-efficacy, knowledge, support, functionality, and information provision about the benefits of e-health for older adults. Key facilitators were active engagement of the target end users in the design and delivery of e-health programs, support for overcoming concerns privacy and enhancing self-efficacy in the use of technology, and integration of e-health programs across health services to accommodate the multi-morbidity with which older adults typically present.ConclusionE-health offers a potential solution to overcome the barriers faced by older adults to access timely, effective, and acceptable health care for physical and mental health. However, unless the barriers and facilitators identified in this review are addressed, this potential will not be realised.

Digital Health During COVID-19 Pandemic: Challenges and opportunities Review

Corona virus pandemic caused an enormous effect on medical care, public activity, and economies on a worldwide scale. Clearly, technology has a vital role to empower omnipresent and available digital health services in pandemic conditions just as against “reappearance” of COVID-19 disease in a post-pandemic period. Likewise, 5G systems and 5G-empowered e-health arrangements are principal. This paper features philosophies to adequately use 5G for e-health use cases and its job to empower significant digital healthcare services. It's anything but a comprehensive conversation of the implementation issues, potential cures and future research bearings for 5G to lighten the health challenges related to COVID-19.

EHealth interventions for reducing cardiovascular disease risk in men: a systematic review and meta-analysis

Abstract Funding Acknowledgements Type of funding sources: Public grant(s) – National budget only. Main funding source(s): Department for the Economy (DfE) studentships Background. Men remain at a higher risk of developing cardiovascular disease (CVD) than women and behavioral risk factor modification is an important preventive measure. However, engaging men in behavior change interventions is challenging. eHealth interventions have the potential to address this gap, though their effectiveness for reducing CVD risk in men is unclear. Purpose. To conduct a systematic review and meta-analysis to evaluate the effectiveness of eHealth interventions for reducing CVD risk in men. Methods. This review was conducted in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) statement and principles laid out by the Cochrane Handbook for Systematic Reviews of Interventions. A search of published randomised controlled trials (RCTs) with no date restrictions up to July 2020 was conducted across five electronic databases: Cochrane Central register of Controlled Trials (CENTRAL), Medline, CINAHL Plus, PsycINFO and SCOPUS. Reference lists of relevant systematic reviews and meta-analyses were manually searched for additional trials not identified during the database search. Eligible studies were RCTs that focused on the use of eHealth to improve a minimum of two major CVD related risk factors in males aged 18 years or older. Results. A total of 3168 records were retrieved from the online database search, with nine trials meeting the inclusion criteria following screening and full-text assessment. Study quality ranged from low to unclear, with one trial at a high risk of bias. Compared to those in a control group or receiving printed materials, participants randomised to an eHealth intervention had statistically significant improvements in BMI (Z=-2.75, p = 0.01), body weight (Z=-3.25, p = 0.01), waist circumference (Z=-2.30, p = 0.02) and systolic (Z=-3.57, p = 0.01) and diastolic (Z=-3.56, p = 0.01) blood pressure. Though less evident, there were also improvements in physical activity and diet in favour of the intervention group. Conclusion. This was the first systematic review and meta-analysis conducted on the effectiveness of eHealth interventions for reducing CVD risk in men. This review suggests that eHealth interventions can reduce CVD risk in adult men through behavior change. However, we were unable to determine the association between intervention characteristics and outcomes. Also, overall, participant adherence to the intervention was poor. Both of these issues should be considered in future studies.

Disparities in access to mobile devices and e-health literacy among breast cancer survivors

BackgroundThe number of e-health interventions developed for breast cancer survivors continues to increase. However, issues with engagement and retention are common. This study aimed to explore e-health literacy rates and access to smartphones and tablets in a large sample of breast cancer survivors.MethodsIn study 1, women were recruited from outpatient breast clinics across England and Wales. Eligible women were asked to complete a questionnaire pack to assess their access to devices and their e-health literacy. Multiple regression analyses were run to assess the relationship between technology access and e-health literacy with sociodemographic variables such as age, social deprivation, and education. Study 2 presents a smaller sample recruited through social media who answered a questionnaire relating to use of mobile devices and e-health, and apps.ResultsTwo thousand nine women participated in the study. Seventy-one percent had access to a smartphone, 54% had access to a tablet, and 20% did not have access to either device. Multiple logistic regressions showed that women who were younger, had higher levels of education, and who were from less deprived areas were more likely to have access to either device. Poorer e-health literacy was associated with being older, having less education, and not having access to a mobile device.ConclusionsWhilst the results show relatively widespread access to mobile devices, there is evidence of a digital divide across some groups. Online interventions should be developed with consideration of individuals who are less e-health-literate and less technologically adept in order to increase the likelihood of engagement.

Worldwide experiences and opinions of healthcare providers on eHealth for patients with interstitial lung diseases in the COVID-19 era.

The #COVID19 pandemic has led to an increase in the use of eHealth for patients with interstitial lung disease. Healthcare providers worldwide are positive towards further implementation of eHealth for research and clinical practice. https://bit.ly/3h2545M

The Increasing Importance of the e-Health System after the COVID-19 Outbreak with New Healthcare Expectations

Aim: The health system is undergoing a rapid transformation with the constantly developing world. The Covid-19 pandemic that threatens humanity seems to change the health system as in every field. The study aimed to determine the use of the e-Health system before and after the pandemic and how health services have changed after the pandemic. Methods: The study was designed with a mixed method that includes analysis of qualitative and quantitative data. The quantitative data of the study were collected with the help of a questionnaire before the pandemic. Qualitative data acquisition and analysis were carried out after the pandemic. Results: According to the results of the study, the rate of participants who did not use the e-Health system before the pandemic was 73.5% (n=155). When asked about the reasons for not using the e-Health system; 43.2% of the participants (n=67) stated that they did not need it, 28.4% (n=44) were not aware of the system and 28.4% (n=44) stated that they did not know how to use the system. According to the qualitative data results, five main themes were obtained after the Covid -19 outbreak. The themes were; getting health information and guidance remotely during the pandemic is the best alternative, creating a sense of trust, compliance with the new situation, expectations from the health system in the new period, and expectations for guidance in accessing e-health information. Conclusion: The most important result of this study, the increase in the use of distance health and e-health, seems to be the framework of the new health service. When the results are read in this context, it can be predicted that a large share of the investments in the field of health will be shifted to digital health systems. Keywords: e-Health, digital health, COVID-19, expectations, pandemics

EHealth Technology: What Do We Know and What do We Need to Learn

eHealth is the use of information and communication technologies for health. eHealth serves multiple utilization purposes for storage, exchange, and retrieval of digital data for administrative, clinical, educational and research purposes. The ultimate purpose of the eHealth use globally is to promote health for individuals efficiently and effectively [1]. A growing body of evidence reveals potential benefits of eHealth on delivery of health care that are cost-effective and responsive to patient’s needs without compromising the quality of service [2]. Systematic reviews revealed promising results on improvement of patient outcomes with implementation of eHealth services [3] especially with challenging behavioral lifestyle modifications such as improving medication adherence [4] physical activity [5] and HIV prevention [6] as well as addressing mental health [7]. With the continuous evolution of eHealth services, challenges to its application and utilization are on rise. Systematic review identified multiple challenges. First, stakeholders and systems users need to have enough training to use the eHealth technology effectively and optimally. Second, the robustness of the technology and its interoperability such as integrity of data and security concerns [8]. Third, capital and startup costs and maintenance can be too costly. Fourth, legal clarity and legal framework challenge relates to legal issues such as privacy [9]. Fifth, organizational context pertains to the environment where eHealth technology is utilized [10]. A critical focus on the emerging technologies currently provides the next context for the integration of eHealth data in every aspect of human activity. The Internet of Things will cause an unpredicted explosion in the delivery of directed custom-made eHealth services to human beings; and thus, the new generation of eHealth data movement will exploit this feature to its full potential. In a way the matching of eHealth services to human needs will incorporate the identification, distribution, and management of many machine-generated eHealth data. With the most documented challenges reported, what are the lessons learnt and how do we tackle them? Opportunities for confronting such challenges are proposed. Investment in advancing competencies of human resources in relation to information systems design and implementation as deemed crucial for optimal utilization of eHealth technology. Governments and national bodies should support eHealth technology to achieve its optimal purposes and become incorporated in health organizations. Researchers and clinicians also need to learn how to apply eHealth technology fully to extend their ability to study and influence health behavior as well as engage patients.

The use of E-health during the COVID-19 pandemic: a case study in China’s Hubei province

ABSTRACT Globally, the use of e-health has accelerated dramatically during the coronavirus pandemic. Based on both quantitative and qualitative data collected in China’s Hubei province (i.e. the first epicentre of COVID-19), this research explores how the pandemic influences the practices of e-health from the perspective of users. Through analysis of 1,033 surveys and 14 in-depth interviews, we find that e-health has played a crucial role in residents’ healthcare during the COVID-19 pandemic. Certain external factors influence the choice of digital health, including the high risk of infection outdoors, the shutting down of transport systems, and dysfunctional healthcare facilities that neglect non-COVID-19 patients’ clinical demands. Against this backdrop, we argue digital health acts as a functional equivalent to traditional medical treatment and has largely satisfied patients and users in the crisis period. Additionally, the COVID-19 pandemic has unintentionally sped up the diffusion of digital medicine over the long term as respondents expressed their willingness to continue use of e-health in the post-COVID-19 phase. However, we assert that despite the increasing use of e-health, it cannot fully substitute traditional offline treatment. Thus, we suggest a combination of online and offline healthcare will be more commonly practiced in the future.

The use of ehealth to promote physical activity in people living with Parkinson’s disease: A systematic review

BACKGROUND: People living with Parkinson’s disease (PD) are less active than healthy individuals. Ehealth is an emerging concept in healthcare which presents opportunities to promote physical activity (PA) in people with PD. The aim of this systematic review was to explore the effectiveness of ehealth in the promotion of PA in people living with PD. METHODS: Suitable articles were searched for using EMBASE, PsychInfo, Web of Science and OVID Medline databases using a combination of keywords and medical subject headings. Articles were included if they described an ehealth intervention designed to promote PA in people living with PD. Two reviewers screened studies for suitability and extracted data. Risk of bias was assessed using the Cochrane risk of bias 2 tool and the Downs and Black risk of bias checklist. Due to the heterogeneity of studies, a narrative synthesis of study interventions and results was completed rather than a quantitative analysis. RESULTS: 1449 articles were screened. Four studies met the eligibility criteria which included 652 participants. Web and mobile applications were used to design the PA interventions. PA levels were measured using self-reported questionnaires, Fitbits, activity monitors and accelerometers. Three of the studies reported improvements in aspects of PA. However, this was not consistently reported in all study participants. No adverse effects, a high level of enjoyment and a relatively low attrition rate (∼12.5%) were reported. CONCLUSION: Ehealth is a safe and feasible intervention to promote PA in this population. It is unclear whether ehealth is effective at promoting PA in people with PD.

PDB43 eHealth Use Among Type 2 Diabetics: PRE-COVID Associations with Patient Activation, Preventive Behaviors, and Health Outcomes

In the aftermath of COVID, there is an increased need to understand the utility of electronic health technologies (eHealth) in the self-management of chronic health conditions.

Use of e-Health by Healthcare Professionals vs. non-Healthcare Professionals.

The role of e-health is increasing worldwide. We surveyed the use of e-health in a large-scale population-based study, involving a representative sample of the Norwegian population aged above 40 years. Two-thirds of the health professionals had used search engines, apps, social media or video services for health purposes - while this was the case for approximately half of the non-health professionals.

An eHealth Framework for Managing Pediatric Growth Disorders and Growth Hormone Therapy.

BackgroundThe use of technology to support health and health care has grown rapidly in the last decade across all ages and medical specialties. Newly developed eHealth tools are being implemented in long-term management of growth failure in children, a low prevalence pediatric endocrine disorder.ObjectiveOur objective was to create a framework that can guide future implementation and research on the use of eHealth tools to support patients with growth disorders who require growth hormone therapy.MethodsA total of 12 pediatric endocrinologists with experience in eHealth, from a wide geographical distribution, participated in a series of online discussions. We summarized the discussions of 3 workshops, conducted during 2020, on the use of eHealth in the management of growth disorders, which were structured to provide insights on existing challenges, opportunities, and solutions for the implementation of eHealth tools across the patient journey, from referral to the end of pediatric therapy.ResultsA total of 815 responses were collected from 2 questionnaire-based activities covering referral and diagnosis of growth disorders, and subsequent growth hormone therapy stages of the patient pathway, relating to physicians, nurses, and patients, parents, or caregivers. We mapped the feedback from those discussions into a framework that we developed as a guide to integration of eHealth tools across the patient journey. Responses focused on improved clinical management, such as growth monitoring and automation of referral for early detection of growth disorders, which could trigger rapid evaluation and diagnosis. Patient support included the use of eHealth for enhanced patient and caregiver communication, better access to educational opportunities, and enhanced medical and psychological support during growth hormone therapy management. Given the potential availability of patient data from connected devices, artificial intelligence can be used to predict adherence and personalize patient support. Providing evidence to demonstrate the value and utility of eHealth tools will ensure that these tools are widely accepted, trusted, and used in clinical practice, but implementation issues (eg, adaptation to specific clinical settings) must be addressed.ConclusionsThe use of eHealth in growth hormone therapy has major potential to improve the management of growth disorders along the patient journey. Combining objective clinical information and patient adherence data is vital in supporting decision-making and the development of new eHealth tools. Involvement of clinicians and patients in the process of integrating such technologies into clinical practice is essential for implementation and developing evidence that eHealth tools can provide value across the patient pathway.

What’s the Name of the Game? The Impact of eHealth on Productive Interactions in Chronic Care Management

Chronic care management is dependent on productive interactions between patients and healthcare professionals. Digital health technologies (eHealth) open up new possibilities for improving the quality of care, but there is a limited understanding of what productive interactions entail. This study explores characteristics of productive interactions to support self-care and healthcare in the context of eHealth use in diabetes care. We collected qualitative data based on interviews with nurses and responses to open-ended survey questions from patients, prior to and post using an eHealth service for self-monitoring and digital communication. We found that eHealth’s influence on productive interactions was characterized by unconstrained access, health parameter surveillance, and data-driven feedback, with implications for self-care and healthcare. Our findings indicate that eHealth perforates the boundaries that define interactions under traditional, non-digital care. This was manifested in expressions of uncertainty and in blurred boundaries between self-care and healthcare. We conclude that the attainment of a sustainable eHealth ecosystem will require healthcare to acknowledge eHealth as a disruptive change that may require re-organization to optimally support the productive use of eHealth services for both patients and staff, which includes agreement on new routines, as well as social interaction rules.

The Uptake and Use of Telemonitoring in Chronic Care Between 2014 and 2019: Nationwide Survey Among Patients and Health Care Professionals in the Netherlands.

BackgroundTelemonitoring could offer solutions to the mounting challenges for health care and could improve patient self-management. Studies have addressed the benefits and challenges of telemonitoring for certain patient groups.ObjectiveThis paper will examine the nationwide uptake of telemonitoring in chronic care in the Netherlands from 2014 to 2019 by means of an annual representative survey among patients and health care professionals.MethodsBetween 2014 and 2019, approximately 2900 patients with chronic diseases, 700 nurses, and 500 general practitioners (GPs) and medical specialists received a questionnaire. About 30 questions addressed topics about the use of eHealth and experiences with it, including data about telemonitoring.ResultsBetween 2014 and 2019, the use of telemonitoring remained stable for all groups except medical specialists. In medical specialist departments, the use of telemonitoring increased from 11.2% (18/161) in 2014 to 19.6% (36/184) in 2019 (χ24=12.3; P=.02). In 2019, telemonitoring was used by 5.8% (28/485) of people with chronic disease. This was 18.2% (41/225) in GP organizations and 40.4% (44/109), 38.0% (78/205), and 8.9% (29/325) in the organizations of nurses working in primary, secondary, and elderly care, respectively. Up to 10% of the targeted patient group such as diabetics were regarded by health care professionals as suitable for using telemonitoring. The main benefits mentioned by the patients were “comfort” (421/1043, 40.4%) and “living at home for longer/more comfortably” (334/1047, 31.9%). Health care professionals added “improvement of self-management” (63/176, 35.8% to 57/71, 80.3%), “better understanding of the patient’s condition” (47/176, 26.7% to 42/71, 59.2%), “reduction of workload” (53/134, 39.6% of nurses in elderly care), “better tailoring of care plan to the patient’s situation” (95/225, 42.2% of GPs), and “saves time for patients/caregivers” (61/176, 34.7% of medical specialists). Disadvantages mentioned by professionals were that “it takes time to monitor data” (13/130, 10% to 108/225, 48.0%), “it takes time to follow up alerts” (15/130, 11.5% to 117/225, 52.0%), and “it is difficult to estimate which patients can work with telemonitoring” (22/113, 19.5% to 94/225, 41.8%).ConclusionsThe uptake of telemonitoring in Dutch chronic care remained stable during 2014-2019 but increased among medical specialists. According to both patients and professionals, telemonitoring improves the quality of life and quality of care. Skills for suitably including eligible patients and for allocating the tasks of data monitoring and follow-up care within the team would help to further increase the use of telemonitoring.

ANALYSIS OF ACCEPTANCE OF E-HEALTH APPLICATION BY USERS IN PRIMARY HEALTHCARE CENTER IN SURABAYA CITY

This study used the observational quantitative method to analyze the acceptance of information technology in the form of thee-Health. The theory of acceptance was further analyzed using the Unified Theory of Acceptance and Use of Technology (UTAUT) model. UTAUT model is the latest unified model that is an appropriate to explain the acceptance and use of information systems. The research objective was to analyze perceptions of the use of e-Health applications in the Surabaya City Health Center. The research design method used was cross-sectional design. The selected samples of 100 people were determined by multistage sampling in primary healthcare centers in every area of Surabaya. The independent variables in this study were performance expectancy, effort expectancy, social influence and behavioral intention while the dependent variable was the use of e-Health applications. Data were collected through questionnaires delivered via interviews. The results showed that the lowest indicator of acceptance by the users was the time needed to input data category to the e-Health application. This study concludes that the acceptance of e-Health by users primary healthcare centers in Surabaya is low. This study suggests a more widespread dissemination of information regarding the benefits of the use of e-Health along with technical assistance and guidance on the use of e-Health applications.Keywords: UTAUT Model, e-Health application, primary healthcare center, acceptance

Using e-health tools and PROMs to support self-management in patients with inflammatory bowel disease

The use of digital health or e-health is growing. The potential positive impact on IBD care from supported self-management using these tools emerged from a literature review carried out in preparation for a service improvement project. A patient-reported outcomes measure (PROM) with validation across IBD sub-types was already available for use. This internationally recognised tool has potential for use with existing or new e-health systems. In order to test the concept of using PROMs to support practice and follow up a small-scale pilot study was designed. The aim of the study was to understand if empowering patients to undertake supported self-management could lead in turn to improved flow through outpatient services. An audit was carried out of PROMs looking at quality of life (QoL) as well as disease activity using an electronic platform in real time at the point of patient contact. The disease activity indices used were the Harvey Bradshaw Index and the Simple Clinical Colitis Activity Index, due to the author's familiarity with these tools. Of the 15 participants, 10 reported themselves as 'well' or 'well with questions' all participants reported an acceptance of supported remote self-management using e-health. This evaluation led to PROMs being captured on a tablet in the outpatient setting in the pre-pandemic period. Allowing patients to use the PROM as a tool in the outpatient setting has led to longitudinal data being added to the e-health system for each individual. Well patients could be managed remotely, freeing capacity in outpatient clinics.

EHealth for patients with rare diseases: the eHealth Working Group of the European Reference Network on Rare Multisystemic Vascular Diseases (VASCERN)

BackgroundThe European Reference Network on Rare Multisystemic Vascular Diseases (VASCERN) was launched in 2017 and involves, to date, 35 highly specialised multidisciplinary expert centres (from the 30 full Healthcare Provider members) coming from 11 countries and more than 70 patient organizations from 16 countries. The eHealth Working Group (WG) of VASCERN was set up to develop practical, patient-centred solutions and strategies for effective use of eHealth tools to answer the needs of patients with multisystemic vascular rare diseases.The eHealth WGFollowing the identified patients’ needs and following the guiding principles of collaboration and patient-centredness, the eHealth WG was created with the following aims: to develop a mobile app to help patients find expert centres and patient organizations, and to develop resources (Pills of Knowledge, PoK) for training and education via digital platforms (eLearning). The mobile app includes, to date, functionalities that allow users to find expert centres and patient organizations across Europe in the area of rare multisystemic vascular diseases. Discussed app developments include personalized digital patient passports, educational material, emergency management guidelines and remote consultations. Regarding training and education, a variety of PoK have been developed. The PoK cover several topics, target several user groups, and are delivered in various formats so that they are easy-to-use, easy-to-understand, informative, and viable for delivery and sharing through digital platforms (eLearning) including, e.g., the VASCERN YouTube™ channel.ConclusionOverall, the work carried out by the eHealth WG of VASCERN can be seen as a pilot experience that may serve as a basis to for collaborative development of patient-centred eHealth tools that answer the needs of patients with various rare diseases, not limited to rare multisystemic vascular diseases. By expanding the multidisciplinary approach here described, clinical and research networks can take advantage of eHealth services and use them as strategic assets in achieving the ultimate goal of ensuring equity of access to prevention programs, timely and accurate diagnosis and specialized care for patients with rare diseases throughout Europe.

Use of eHealth for HIV Medical Education: a Narrative Review

The complexity of HIV care and its expanding clinical workforce has created a need for new distance learning models to deliver medical education. We conducted a narrative review to assess the acceptability and effectiveness of recent eHealth HIV education interventions supporting HIV healthcare providers. Evidence from 24 articles revealed that synchronous (real time), asynchronous (any time), and hybrid (combination) models of eHealth education are feasible and acceptable. Only two interventions (one asynchronous, one hybrid) of 19 included in the review utilized a randomized controlled design. Some studies showed improvement in confidence and perceived quality of case management, but few studies were designed to demonstrate impact. Successful eHealth education interventions require a thorough understanding of the target community's capacity and needs. Both synchronous and asynchronous strategies appear acceptable and potentially effective, but more studies are needed to assess impact on knowledge and practices to determine the most effective delivery models.

Understanding Technology Fit Among People with HIV Based on Intersections of Race, Sex, and Sexual Behavior: An Equitable Approach to Analyzing Differences Across Multiple Social Identities.

HIV disproportionately impacts individuals based on intersecting categories (e.g. gender, race/ethnicity, behavior), with groups most at-risk deemed priority populations. Using weighted effects coding to account for differential group sizes, this study used multilevel mixed logistic models to investigate differences in eHealth use and willingness to use eHealth for HIV-related information among priority populations. Compared to the sample average, Black men who had sex with women were less likely to use all technologies except cellphones with text-messaging and less likely to be willing to use computers and tablets. White and Hispanic men who had sex with men were more likely to use all technologies. No significant differences existed for use or willingness to use cellphones with text-messaging. Future research should consider approaches used here to account for equity and multiple intersecting social identities; practitioners may use these findings or similar local data to ensure fit between eHealth programs and priority populations.

Use of Electronic Health (eHealth) Among Saudi Type 2 Diabetic Patients and Its Association With Their Diabetic Self-Management: A Cross-Sectional Study.

BackgroundType 2 diabetes mellitus (T2DM) is a prevalent, chronic, non-communicable disease that requires continuous multidisciplinary health care. Electronic health (eHealth) refers to “the transfer of health information resources and health care services using different electronic platforms.” This may have an effect on diabetes self-management (DSM).ObjectivesThis study aimed to identify the use of eHealth among patients with T2DM as well as its association with DSM.MethodAn analytical cross-sectional study was conducted online using a newly adapted three-part questionnaire using Google Forms through different social media platforms. A total of 2,228 adult Saudi T2DM patients from different provinces were selected based on the non-probability voluntary response sampling technique. The survey included demographic, clinical, and eHealth data, and diabetic self-care management.ResultsThe study results revealed an average DSM score of 5.2/10, and 74.1% were receiving diabetes care at primary health care centers. Of these, 87.1% used eHealth, mainly through Google (55.7%) and other social media (12.9%), and were satisfied with the quality of health care (70.4%). Moreover, 82% wanted to discuss the eHealth information with their physicians, but some (34.5%) had no online access to them. eHealth dependency was 44.2% and was associated with a lower mean DSM (5.6 vs. 5.3; p = 0.000) with significantly lower health care use (6.7 vs. 5.6; p = 0.000) and glucose management (4.7 vs. 4.0, p=0.000) compared to the independent group. The DSM total score was a significant predictor of eHealth dependency (OR: 1.022; 95% CI: 1.006-1.039; p = 0.007).ConclusionMost Saudi T2DM patients with an average DSM use different eHealth resources and are satisfied with their quality. Dependency to eHealth is significantly associated with lower DSM, especially for health care use and glucose management, a finding that could affect patient outcomes. Still, patients need to communicate with their physicians in person who should have different options for remote consultation, such as telemedicine, to support their patients.