Internet access and use by COPD patients in the National Emphysema/COPD Association Survey

BACKGROUND: Technology offers opportunities to improve healthcare, but little is known about Internet use by COPD patients. We tested two hypotheses: Internet access is associated with socio-demographic disparities and frequency of use is related to perceived needs. METHODS: We analyzed data from a 2007-2008 national convenience sample survey of COPD patients to determine the relationship between Internet access and frequency of use with demographics, socio-economic status, COPD severity, and satisfaction with healthcare. RESULTS: Among survey respondents (response rate 7. 2%; n = 914, 59. 1% women, mean age 71. 2 years), 34. 2% reported lack of Internet access, and an additional 49% had access but used the Internet less than weekly. Multivariate models showed association between lack of access and older age (OR 1. 10, 95% CI 1. 07, 1. 13), lower income (income below 30, 000 OR 2. 47, 95% CI 1. 63, 3. 73), less education (high school highest attainment OR 2. 30, 95% CI 1. 54, 3. 45), comorbid arthritis or mobility-related disease (OR 1. 56, 95% CI 1. 05, 2. 34). More frequent use (at least weekly) was associated with younger age (OR 0. 95, 95% CI 0. 93, 0. 98), absence of cardiovascular disease (OR 0. 48, 95% CI 0. 29, 0. 78), but with perception of needs insufficiently met by the healthcare system, including diagnostic delay (OR 1. 72, 95% CI 1. 06, 2. 78), feeling treated poorly (OR 2. 46, 95% CI 1. 15, 5. 24), insufficient physician time (OR 2. 29, 95% CI 1. 02, 5. 13), and feeling their physician did not listen (OR 3. 14, 95% CI 1. 42, 6. 95). CONCLUSIONS: An analysis of the characteristics associated with Internet access and use among COPD patients identified two different patient populations. Lack of Internet access was a marker of socioeconomic disparity and mobility-associated diseases, while frequent Internet use was associated with less somatic disease but dissatisfaction with care.