Identifying the Challenges in Self-Management and Preferences for Digital Health Technologies Use Among COPD Patients Based on the CeHRes Roadmap: A Formative Qualitative Study.

Abstract

Background: Digital health technologies offer a promising approach to strengthening self-management capacity among patients with chronic obstructive pulmonary disease (COPD), yet clinical application is hampered by poor adherence, low sustained engagement, and limited self-management ability. Although previous studies have identified general self-management challenges in COPD, few have systematically investigated patients' preferences for digital tools or translated these insights into actionable design principles. This hinders the user-centred development and effective deployment of digital interventions for this population.

Objective: This study aimed to explore the self‑management challenges and preferences for mobile health (mHealth) among COPD patients, with the ultimate goal of translating these findings into design principles for a persuasive self‑management application.

Methods: We conducted in-depth personal interviews with 15 patients with COPD and five healthcare professionals to explore the challenges of self-management and preferences for mHealth. Data were analyzed using thematic analysis. Subsequently, a structured expert consultation was held to translate the findings into key principles for a persuasive self-management application.

Results: Five themes regarding barriers to effective self-management were identified: (1) negative emotional experience, (2) poor health literacy, (3) insufficient family support, (4) inadequate professional health care, and (5) economic burden. Patients expressed four key preferences for digital health technologies: (1) simplicity, (2) personalized decision support, (3) self-report, (4) early warning of deterioration. Furthermore, the panel discussion distilled these findings into eight essential key principles: motivation, simplicity, credibility, guidance, personalization, self-report, warning, and continuity.

Conclusion: This study provides new insights into user-centered mHealth tools for COPD self-management. We derived core design principles from patients' demands to inform targeted digital interventions. These principles require validation in female, higher-literacy and multi-center samples before wide application. Future work will complete the remaining CeHRes Roadmap stages of design, operationalization and evaluation to refine this framework.