Facilitators and barriers affecting the implementation of e-health for chronic respiratory diseases in remote settings: a qualitative evidence synthesis
Abstract Background Chronic respiratory diseases are important causes of disability and mortality globally. Their incidence may be higher in remote locations where healthcare is limited and risk factors, such as smoking and indoor air pollution, are more prevalent. E-health could overcome some healt...
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| Format: | Article |
| Language: | English |
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BMC
2025-01-01
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| Series: | BMC Health Services Research |
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| Online Access: | https://doi.org/10.1186/s12913-024-12050-4 |
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| author | Emil Matias Salmi Francesca Wanda Basile Faiz Ahmad Khan Larry Watt Rinn Song Else Margreet Bijker |
| author_facet | Emil Matias Salmi Francesca Wanda Basile Faiz Ahmad Khan Larry Watt Rinn Song Else Margreet Bijker |
| author_sort | Emil Matias Salmi |
| collection | DOAJ |
| description | Abstract Background Chronic respiratory diseases are important causes of disability and mortality globally. Their incidence may be higher in remote locations where healthcare is limited and risk factors, such as smoking and indoor air pollution, are more prevalent. E-health could overcome some healthcare access obstacles in remote locations, but its utilisation has been limited. An improved understanding of barriers and facilitators to the implementation of e-health in remote locations could aid enhanced application of these approaches. Methods We performed a qualitative evidence synthesis to explore factors affecting the successful implementation of e-health interventions in remote locations for patients with chronic respiratory diseases. We searched PubMed, CINAHL, Embase, Web of Science and PsycINFO databases for qualitative and mixed-methods studies. Studies were assessed by two researchers, and 41 studies were included in the synthesis. Quality was assessed via the CASP-tool. Findings were coded with Atlas.ti software and categorised based on an adapted Digital Health Equity Framework. Results Nineteen themes were identified across five levels (individual, interpersonal, community, society and technology), with associated facilitators and barriers for implementation. An important facilitator of e-health was its role as a tool to overcome obstacles of distance and to increase access to care and patients’ self-efficacy. Potential barriers included the reduction of in-person interactions and an increased burden of work for healthcare providers. Good quality, usability, adaptability and efficacy of e-health interventions were important for implementation to be successful, as were adaptation to the local setting — including culture and language —and involvement of relevant stakeholders throughout the process. Conclusions Several factors affecting the implementation of e-health in remote and rural locations for patients with chronic respiratory disease were identified. Intervention objectives, target population, geographical location, local culture, and available resources should be carefully considered when designing an e-health intervention. These findings can be used to inform the successful design and implementation of future e-health interventions. |
| format | Article |
| id | doaj-art-f0cea15689a7498880cd0356f5ad2019 |
| institution | Kabale University |
| issn | 1472-6963 |
| language | English |
| publishDate | 2025-01-01 |
| publisher | BMC |
| record_format | Article |
| series | BMC Health Services Research |
| spelling | doaj-art-f0cea15689a7498880cd0356f5ad20192025-01-05T12:12:28ZengBMCBMC Health Services Research1472-69632025-01-0125112210.1186/s12913-024-12050-4Facilitators and barriers affecting the implementation of e-health for chronic respiratory diseases in remote settings: a qualitative evidence synthesisEmil Matias Salmi0Francesca Wanda Basile1Faiz Ahmad Khan2Larry Watt3Rinn Song4Else Margreet Bijker5Department of Paediatrics, Maastricht University Medical Center, MosaKids Children’s HospitalDepartment of Paediatrics, Oxford Vaccine Group, University of OxfordRespiratory Epidemiology & Clinical Research Unit, Centre for Outcomes Research & Evaluation, Research Institute of the McGill University Health Centre and Respiratory Division, McGill UniversityUngava Tulattavik Health CentreDepartment of Paediatrics, Oxford Vaccine Group, University of OxfordDepartment of Paediatrics, Maastricht University Medical Center, MosaKids Children’s HospitalAbstract Background Chronic respiratory diseases are important causes of disability and mortality globally. Their incidence may be higher in remote locations where healthcare is limited and risk factors, such as smoking and indoor air pollution, are more prevalent. E-health could overcome some healthcare access obstacles in remote locations, but its utilisation has been limited. An improved understanding of barriers and facilitators to the implementation of e-health in remote locations could aid enhanced application of these approaches. Methods We performed a qualitative evidence synthesis to explore factors affecting the successful implementation of e-health interventions in remote locations for patients with chronic respiratory diseases. We searched PubMed, CINAHL, Embase, Web of Science and PsycINFO databases for qualitative and mixed-methods studies. Studies were assessed by two researchers, and 41 studies were included in the synthesis. Quality was assessed via the CASP-tool. Findings were coded with Atlas.ti software and categorised based on an adapted Digital Health Equity Framework. Results Nineteen themes were identified across five levels (individual, interpersonal, community, society and technology), with associated facilitators and barriers for implementation. An important facilitator of e-health was its role as a tool to overcome obstacles of distance and to increase access to care and patients’ self-efficacy. Potential barriers included the reduction of in-person interactions and an increased burden of work for healthcare providers. Good quality, usability, adaptability and efficacy of e-health interventions were important for implementation to be successful, as were adaptation to the local setting — including culture and language —and involvement of relevant stakeholders throughout the process. Conclusions Several factors affecting the implementation of e-health in remote and rural locations for patients with chronic respiratory disease were identified. Intervention objectives, target population, geographical location, local culture, and available resources should be carefully considered when designing an e-health intervention. These findings can be used to inform the successful design and implementation of future e-health interventions.https://doi.org/10.1186/s12913-024-12050-4E-healthTelemonitoringRespiratory diseaseCOPDAsthmaChronic |
| spellingShingle | Emil Matias Salmi Francesca Wanda Basile Faiz Ahmad Khan Larry Watt Rinn Song Else Margreet Bijker Facilitators and barriers affecting the implementation of e-health for chronic respiratory diseases in remote settings: a qualitative evidence synthesis BMC Health Services Research E-health Telemonitoring Respiratory disease COPD Asthma Chronic |
| title | Facilitators and barriers affecting the implementation of e-health for chronic respiratory diseases in remote settings: a qualitative evidence synthesis |
| title_full | Facilitators and barriers affecting the implementation of e-health for chronic respiratory diseases in remote settings: a qualitative evidence synthesis |
| title_fullStr | Facilitators and barriers affecting the implementation of e-health for chronic respiratory diseases in remote settings: a qualitative evidence synthesis |
| title_full_unstemmed | Facilitators and barriers affecting the implementation of e-health for chronic respiratory diseases in remote settings: a qualitative evidence synthesis |
| title_short | Facilitators and barriers affecting the implementation of e-health for chronic respiratory diseases in remote settings: a qualitative evidence synthesis |
| title_sort | facilitators and barriers affecting the implementation of e health for chronic respiratory diseases in remote settings a qualitative evidence synthesis |
| topic | E-health Telemonitoring Respiratory disease COPD Asthma Chronic |
| url | https://doi.org/10.1186/s12913-024-12050-4 |
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