Towards Inclusive E-Health Strategies: Assessing the Digital Literacy in Spanish Chronic Patients

OBJECTIVES: To understand how chronic patients interact with the healthcare system in Spain and their proficiency using digital tools.

METHODS: A survey was conducted on 800 chronic patients in September 2023, using an IQVIA panel of 400 pharmacies spread across Spain. The healthcare professional dispensing the medication directly asked the patients the survey questions, via computer-assisted web interviewing techniques. The sample was composed of patients with the following groups of chronic conditions: diabetes (n=200), COPD and asthma (n=200), risk of thrombosis (n=200), and transplant-related conditions (n=200). The results were categorized by medical condition, sex, and age.

RESULTS: The study population consisted of 243 people (30.4%) aged ≥70 years, 240 (30.0%) aged 60-74, 230 (28.8%) aged 40-59, and 87 (10.9%) below 40. Individuals with transplant-related conditions, COPD or asthma were younger (56.5% and 47%, respectively, were aged <60 years old). Females made up 56.6% of the sample, varying from 67.0% among respondents with transplant-related conditions to 49.5% in the at-risk-of-thrombosis group. Most (62.8%) reported general practitioners as their usual point-of-contact, followed by other specialists (30.6%), pharmacists (4.5%), and nurses (2.1%). Regarding digital proficiency, 29.6% stated they could handle technology very well (varying from 9.1% in the oldest and 71.3% in the youngest groups), 23.0% could handle it but would like to be more agile, 25.0% reported difficulties using technology and frequently requiring support from others, and 22.4% avoided using technology whenever possible. The majority scheduled doctor's appointments in-person (59.6%), followed by phone (30.6%) and mobile apps (16.6%). Younger patients were more likely to use apps for scheduling (31.0%) while older patients were less likely (7.8%). In-person medical consultations were reported by most (79.8%), followed by phone consultations (30.9%). Only 2.8% had video consultations.

CONCLUSIONS: There is a need to enhance digital literacy to ensure equal access to e-health for chronic patients.