Had percutaneous coronary intervention, now what? Searching the internet for health information

Abstract

Background/Introduction: Health information and secondary prevention strategies after percutaneous coronary intervention (PCI) are pivotal to reduce the risk of new cardiac events and achieve good quality of life. However, whether patients are digitally active and have sufficient electronic health literacy (eHL) skills to access, understand and use internet-based health information remain unclear. Purpose: To determine the extent to which patients after PCI are digitally active, and determine associations of health related internet use and sociodemographic factors with eHealth literacy. Methods: This study is a sub-study of the prospective, multicenter CONCARDPCI study including >3000 patients after PCI. A total of 1956 patients were included from three Norwegian university hospitals between June 2017 and May 2019. Clinical data were collected through Norwegian Registry of Invasive Cardiology and patient medical records. Sociodemographics were obtained by self-report during index hospitalization. The eHealth Literacy Scale (eHEALS) assessed patient's eHL at baseline, measured on an 8-40 scale. De novo created questions assessed patient's health-related internet use, and use of the national health portal for information was measured at baseline and 2-and 6-month follow-up. Linear regression analysis determined the association between eHEALS, use of the internet, and sociodemographic factors. Results: Most participants were men (78%), mean age 66 years (range; 20-96 years, SD 10.9). A total of 94% of the participants reported to have access to the internet, 67% had used the internet to find health information, and 54% had used the national health portal. After 6 months, patients increased their use of the national health portal (54% to 66%). Use of health applications on mobile phones or tablets increased from 10% to 40% from 2-to 6-month follow-up (P<0.001). At baseline 45% found the internet useful or very useful to make health decisions, and 57% found access to health resources on the internet to be important or very important. However, 50% were uncertain about how to use the information to make decisions about their own health. The eHEALS mean score was low; 25,66 (SD 6,24). Adjusted for sociodemographic factors there was an significant association between eHEALS and use of the internet to find health information at baseline (coefficient 11.41, 95% CI 8.05-14.57, P=0.001). At 2-month follow-up there was an significant association between eHEALS and use of the internet to find information about health, prevention, illness or treatment (coefficient 9.027, 95% CI 6.78-11.06, P=0.001), and the use of health applications (coefficient 3.197, 95% CI 0.24-6.30, P=0.046). Conclusions: This study provided evidence that higher eHL predicts use of the internet to find health information and indicates that eHL and sociodemographic factors have an impact on how patients use, and can make use of, eHealth technology.