Abstract:

Objective:
This study aimed to identify the attitudes and beliefs of healthcare practitioners (HP) regarding the use of a mobile application to increase compliance to a gluten-free diet (GFD) in adolescents with coeliac disease (CD).

Materials and methods:
This study used a qualitative thematic approach and was part of a broader ERASMUS+ programme research initiative involving Hodgeschool van Amsterdam (HvA), Vorarlberg University of Applied Sciences Austria (FHV), University of Seville (US), St. Luke’s Hospital Kilkenny, and the Institute of Technology Carlow (ITC). A needs analysis was conducted in phase 1 of this project via interviews with CD patients, parents and HPs. In phase 2 of the project, mobile applications designed to record the nutritional history, moods and symptoms of CD patients were developed and prototypes were tested on HPs. Participants trialed the prototypes on a smartphone, then completed an electronic questionnaire and a semi-structured interview.

Results:
Twelve HPs (male n=3, female n=9), including paediatricians (25%, 3/12), dietitians (33%, 4/12) and nurses (16%, 2/12) who had experience treating patients with CD, from two public hospitals and one patient advocacy group in Ireland participated in this study. 7 variables and 4 main themes were identified from the electronic questionnaires and semi-structured interviews, respectively. Questionnaire results showed: all participants (100%, 12/12) believed eHealth technologies have potential to positively influence patient quality of care and could improve healthcare service efficiency; 92% (11/12) believed eHealth could be beneficial in patient management; 83% (10/12) believed eHealth technologies are important for teaching patients with chronic disease how to self-manage their symptoms and condition; 83% (10/12) believed self-reported data is useful information and would help gather more accurate information during follow-up appointments; 75% (9/12) would implement a mobile application to monitor adherence to GFD, symptoms and mood; 58% (7/12) of participants trust eHealth technologies as a self-management tool for patients with chronic diseases; and 58% (7/12) did not use eHealth in patient management but would consider using it. Only one in four (25%, 3/12) participants believed eHealth technology is reliable. Thematic analysis of semi-structured interviews showed 4 themes: (1) knowledge of eHealth technology, (2) positive effects of eHealth, (3) barriers of using eHealth, and (4) feedback of prototype mobile applications.

Conclusions:
HPs demonstrated mostly positive attitudes towards eHealth and the use of a mobile application in the management of patients with CD. However, HPs had limited knowledge of eHealth and many expressed concerns regarding its reliability, which may prevent the uptake and implementation of eHealth by HPs. This study shows further training of HPs prior to implementation of eHealth is needed and that more research on the reliability of eHealth should be conducted before eHealth will be fully adopted by HPs.

Keywords:

Celiac disease, celiac disease, eHealth, mobile application, practitioner, compliance.