Understanding How a Digital Platform for Chronic Disease Management Can Enable and Limit Patient Self-Care:...

A growing segment of the population requires ongoing care and support for managing their chronic diseases. Digital platforms for self-management are rapidly emerging to meet this need, but patients' experiences with these platforms vary significantly. This may be due to the complexity and flexibility of digital platforms, where the wide array of available features can generate unexpected impacts.

This study aims to explore how a digital platform can both enable and limit patients with a chronic disease in managing their own health.

We conducted semistructured qualitative interviews with patients to better understand their experience of using a digital platform for self-managing their chronic diseases. Patients who had been using a digital platform (the Chronic Care Platform) for at least 1 month were invited to participate. Twenty-four patients were recruited and interviewed in person or by phone. The collected data were analyzed using template analysis, which is a type of thematic analysis that allows inductive identification of themes from data and deductive application of theory-informed themes. We leveraged Self-Care Theory to understand how patients' motivation to use the platform and their subsequent use of its features generated perceived value and challenges in achieving this value.

The platform was shown to support patients' development of core self-care abilities (cognitive, psychosocial, and sociocultural abilities) and self-care behaviors (maintenance, monitoring, management), but it did not provide any support to the development of physiological abilities. Moreover, results indicate important limitations in the way in which the digital platform supported all self-care abilities and behaviors-in particular, self-care management. Hence, while the platform was viewed as valuable overall, patients reported several challenges in effectively using the Chronic Care Platform for self-care.

Digital platforms for chronic disease management can enhance patient self-care by providing valuable resources and support for reinforcing desired behaviors. However, gaps in platform features can limit patients' ability to comprehensively care for themselves. This study shows that relating platform features to specific dimensions of self-care can help identify missing features, providing a fine-grained understanding of how a given platform is generating positive impacts and how it may be improved to fully support self-care.