Use of Online Self-Management Diaries in Asthma and COPD: A Qualitative Study of Subjects ’ and Professionals ’ Perceptions and Behaviors

BACKGROUND: Online self-management diaries are used to support patients ’ self-management skills and facilitate associated behavioral changes. Although web-based diaries are well-known as a potential self-management tool, reasons that patients use (or do not use) self-management diaries, as well as perceptions and behaviors related to diary use, remain largely unknown. METHODS: Semistructured interviews (n 30) were conducted with health-care professionals and subjects to understand perceptions and behaviors related to self-management diary use for asthma and COPD in 2 hospitals in Rotterdam, The Netherlands. RESULTS: Subjects in this study used self-manage-ment diaries to improve their knowledge of the disease, cope more consciously with their disease, feel in control, and discuss outcomes from the self-management diaries with their health-care professionals. Two subjects reported that they used the self-management diary to cope more effec-tively with their disease and recognized an exacerbation and acted by adjusting their medications. Both health-care professionals and subjects experienced practical barriers in integrating self-man-agement diaries into their regular practices. Subjects ’ reasons for nonuse were related to the intervention, the disease, and subject-provider contact. CONCLUSIONS: Health-care professionals should help patients use self-management diaries by collaboratively developing an individual treat-ment plan and by showing patients how to use the diaries to recognize and act on an exacerbation. Together with the suggestions made for improving the self-management diaries, this will aid in the integration of self-management diaries into regular health-care practice and enhance patients’ self-management of their disease. Key words: chronic disease; self-management; patient education; health-care technology; online self-management diaries; asthma; COPD. [Respir Care 2015;60(8):1146–1156. © 2015 Daedalus Enterprises