Understanding Digital Health Literacy and Attitudes Towards eHealth Technologies Among Cardiovascular Patients: Implications for Secondary Prevention (Preprint)

BACKGROUND Cardiovascular disease is the major cause of death worldwide, leading to a significant socioeconomic burden. Although secondary prevention is a cornerstone in chronic disease management, adherence to guideline recommendations in this regard often falters, leading to suboptimal outcomes. While eHealth technologies are promising for improving treatment adherence, they also represent a new approach to secondary prevention. However, a common critique is that extensive digitalization may not adequately address the needs of older adults with chronic medical conditions. OBJECTIVE This study aims to analyze eHealth literacy, digital usage patterns and general attitude towards digital technologies in a collective of cardiovascular patients to identify potential obstacles in implementing mHealth technologies in secondary preventive therapy. METHODS This survey-based study was a part of the baseline examination of the PreventiPlaque trial. It involved 240 participants with known coronary artery disease. The assessment evaluated their current understanding of the general use of digital devices. The questionnaire covered aspects such as the duration of daily usage, personal attitudes, and the perceived burden associated with digital media. eHealth literacy was assessed within the target population and general demographic data were gathered, focusing on cardiovascular comorbidities and risk factors. RESULTS The analysis revealed an average age of 61.9 years (SD 8.9 years), with 59.9% of the participants being male. Overall, 37.3% of the participants had previous knowledge of digital health interventions, while only 17.8% had utilized them. Despite the generally low practical application within our study population, there was a high level of confidence in handling digital devices, with 61.9% expressing themselves as either rather confident or very confident. Regarding the levels of eHealth literacy in the study collective, 71.2% claimed to be familiar with locating health information on the Internet, and 64% felt capable of critically evaluating its quality. These levels of digital confidence were consistent across all analyzed age groups. Moreover, Internet usage rates remained high even within the elderly collective, with 80% of those over 75 years old using the Internet for one to three hours a day. CONCLUSIONS The study unveiled a notable confidence level among participants regarding the use of digital devices, coupled with a favorable attitude towards digital media evident across all age brackets. Remarkably, Internet usage rates remained high, even among elderly participants. The actual utilization of digital health interventions was relatively low, potentially stemming from challenges in locating reliable sources. These findings emphasize the prospect for future eHealth interventions customized to the distinct needs and preferences of patients in cardiovascular disease management. Recognizing the incongruity between confidence in device use and the restricted adoption of digital health tools can guide the development of focused interventions to narrow this divide. CLINICALTRIAL ClinicalTrials.gov NCT05096637