Improving medication adherence of patients with familial hypercholesterolemia through an eHealth application

Abstract

Background: Statins are the cornerstone in the treatment of patients with familial hypercholesterolemia (FH; a genetic disorder which results in high cholesterol levels). However, a considerable number of patients show non-adherence. Our aim was to design an eHealth application (‘MIK’), based on the concept of patient engagement and discussion of patients’ beliefs, and to evaluate this application among physicians. Methods: A web-based prototype of ‘MIK’ was designed. After user tests with patients, we performed semi-structured interviews and user tests with 12 physicians from six different hospitals. We focused on how the eHealth application could assist physicians in their consultation with the patient and how it can be integrated in daily clinical practice. Qualitative thematic analysis was used to identify themes that covered physicians’ evaluations. Findings: The following themes were identified: (1) information about experienced side effects and quality of life can prompt a discussion about treatment options; (2) information about patients’ treatment preferences, beliefs and expectations can stimulate patient-physician collaboration (i.e. Shared Decision Making); (3) physicians acknowledged the advantage of making connections between patient data (e.g., cholesterol) over time thereby stimulating self-management; (4) Physicians were ambivalent with respect to how the application would impact the efficiency of their consultations. Discussion: The eHealth application ‘MIK’, based on patient engagement and discussion of patients’ beliefs, seem to have the potential to improve the consultation with the physician. The impact of eHealth applications on improving medication taking behavior and clinical outcomes is yet to be evaluated.