Digital health technology burden and frustration among patients with multimorbidity

This study aimed to characterize patterns of digital health technology (DHT) use and examine the relationships between multimorbidity, DHT adoption, and user-reported frustration, with a focus on identifying socioeconomic and phenotypic determinants of digital health burden.

A cross-sectional analysis was conducted using nationally representative public data from Health Information National Trends Survey (HINTS) 7. Adults with at least one chronic condition were included (N = 3753). The outcomes were the number of DHTs used and frustration with digital tools. Multivariable logistic regression models were employed, adjusting for sociodemographic and clinical variables. Phenotypic subgroup analyses were conducted based on multimorbidity, DHT use, and frustration patterns.

Among 3753 participants, 46.9% had multimorbidity. Participants with multimorbidity reported using a greater number of DHTs on average (mean = 3.9 vs 3.6, P < .001) compared to those with a single condition, yet exhibited significantly higher rates of frustration with digital tasks (61.2% vs 54.1%, P < .001). Both higher income and educational groups were associated with lower odds of frustration. Greater DHT use was also independently associated with reduced frustration (OR = 0.78, 95% CI: 0.71-0.87, P < .01). Phenotypic subgroup analysis further identified individuals with multimorbidity and low DHT versatility as the most vulnerable profile, characterized by older age, lower socioeconomic status, and the highest frustration prevalence (60.3%).

While individuals with multimorbidity use more DHTs, they experience greater frustration, particularly those with lower socioeconomic status. However, higher engagement with DHTs (as measured by number of technology types adopted) is associated with lower frustration, suggesting that technology proficiency may mitigate burden. Targeted, equity-conscious interventions, including competency-based digital literacy programs, simplified user-centered design, and structural supports addressing device access and connectivity, are needed to reduce digital health burden and improve outcomes for patients living with multiple chronic conditions.