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Lessons learned from patients with access to an online self-management enhancing program for RA patients: qualitative analysis of interviews alongside a randomized clinical trial.

Zuidema, R., Dulmen, S. van, Nijhuis-van der Sanden M.W.G., Fransen, J., Gaal, B.G.I. van. Lessons learned from patients with access to an online self-management enhancing program for RA patients: qualitative analysis of interviews alongside a randomized clinical trial. Patient Education and Counseling: 2019, 102(6), 1170-1177
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Objective:
This study aims to explain the earlier findings of a Randomized Controlled Trial (RCT), which showed that rheumatoid arthritis (RA) patients did not benefit from an online self-management program. Moreover, less patients than expected used the program.

Methods:
As part of an explorative RCT, patients were interviewed to explore their (non) usage of the program. Purposive sampling (n = 21) was used to select patients from four groups of patients (n = 49): 1) non-users; 2) low users; 3) high users basic; 4) high users plus.

Results:
The program supported only a small group of patients because: 1) not all patients were motivated to use the program, 2) patients had no clear expectation or had differing expectations of the program, 3) there was a mismatch between individual patients’ support needs and the needs included in the program, 4) reminders were only sent to fill in the diaries for pain and fatigue, not to use the program modules.

Conclusion:
This study offers insights in the (non-) usage of online programs and how usage could be increased in practice.

Practical implications:
Health professionals should be involved in the implementation of this online programs and should inform patients what the program could bring them.