Intention to Use Digital Health Among COPD Patients in Europe: A Cluster Analysis.

Area of Science:

• Digital Health
• Chronic Obstructive Pulmonary Disease (COPD)
• Health Technology Acceptance

Background:

• Chronic Obstructive Pulmonary Disease (COPD) presents a growing challenge to European healthcare systems, exacerbated by an aging population.
• Digital health interventions (DHIs) offer potential to reduce hospitalizations and improve self-management for COPD patients.
• Older adults often exhibit hesitancy towards adopting DHIs, necessitating tailored approaches based on patient profiles.

Purpose of the Study:

• To identify distinct patient clusters based on their intention to use digital health interventions (DHIs) among COPD patients.
• To understand the factors influencing the adoption of DHIs in a diverse European COPD population.
• To inform the development of targeted strategies for promoting DHI uptake in COPD management.

Main Methods:

• A cross-sectional survey was conducted with 232 COPD patients across seven European countries between July 2024 and February 2025.
• Data collected included sociodemographic information and constructs from the Unified Theory of Technology Acceptance (UTAUT).
• Patient intention to use DHIs was categorized, and weighted UTAUT scores were clustered using Gower distance and Partitioning Around Medoids.

Main Results:

• Two distinct clusters were identified: 'balanced hesitant' (n=104) with mixed intentions and 'enthusiastic' (n=128) with strong adoption intentions.
• Barriers for hesitant users included low performance expectancy and limited digital skills (p < 0.05).
• Enablers for enthusiastic users involved low effort expectancy and disease complexity (p < 0.01), with performance expectancy consistently predicting intention across both groups.

Conclusions:

• Digital health adoption in COPD is influenced by a combination of psychosocial factors and digital literacy.
• Tailored interventions are needed: hesitant users benefit from expectation-focused information, digital literacy training, and peer support, while enthusiastic users need seamless integration.
• Performance expectancy is a critical driver for DHI adoption, underscoring the need for country-specific strategies.