Digital Inclusion in a Scottish National Pulmonary Hypertension Population

To evaluate current digital inclusion in the Scottish pulmonary hypertension population, a paper questionnaire was offered to the entirety of patients with pulmonary arterial hypertension in Scotland. The Scottish Index of Multiple Deprivation was used to stratify patients into deprivation deciles. 464 patients returned questionnaires (86%). 91% had reliable internet access. 89% had access to an internet-enabled device. 71% used the internet daily. The most common barriers to increased internet usage were confidence with technology (19%) and lack of perceived personal benefit (7%). 54% would like virtual healthcare to complement in person review and 58% would like to monitor their health digitally. Older patients were less likely to use the internet and had less desire for virtual healthcare. Rural living did not negatively impact access to the internet. Younger, more rural, and less deprived patients currently use and desire more online exercise. Deprived patients were less likely to have internet access or internet enabled devices, more likely to have no device or a mobile without internet, and had less desire for virtual healthcare or digital health monitoring. Most patients have the means of accessing the internet and support virtual healthcare in addition to direct clinician contact. However, digital engagement was lower in older and more deprived patients. The high response rate supports paper over online survey methodology for future digital inclusion research. Future digital healthcare strategies need to integrate this knowledge to minimize age- and deprivation-related inequity.