Digital health readiness for Japanese patients with cardiovascular disease

Background Digital health has been increasingly applied to the cardiovascular field, especially since the COVID era. Japan is a super-aged society with an average life expectancy of 81 years for men and 87 years for women in 2023. However, there are no existing tools to measure digital health readiness and learnability to implement "digital cardiology" in such a society. Purpose The purpose of this study is to validate the Japanese translation of the Digital Health Readiness Questionnaire (DHRQ) created in Belgium to assess the digital readiness of Japanese patients with cardiovascular disease. Methods A multicentre cross-sectional study of 210 patients with cardiovascular disease in Kawasaki, an urban, aging city, was conducted at a university hospital and a city hospital. Regarding the translation of the DHRQ, the back translation method was used and the differences between the translated version and the original version were discussed. The DHRQ consists of the DHRQ score and the learnability score. Multivariate analysis and confirmatory factor analysis were performed. Results A total of 208 complete questionnaires were included in the analysis. The average age was higher than in Belgium (68 ± 14 vs. 62 ± 15 years), of which 82 (39%) were female. The highest age was 96 and the lowest was 24. Smartphone ownership was higher than in Belgium (86% vs. 81%), but smartwatch and PC ownership was lower than in Belgium (18% vs. 28% and 54% vs. 87%). In multiple regression analysis, age, education level, and smartphone ownership were significant predictors of DHRQ and learnability scores (p ≤ 0.001), while gender and income were not significant predictors. Cronbach's alpha analysis was above 0.8 for all domains of the DHRQ, which implied acceptable internal consistency. The fit indices of the confirmatory factor analysis (Table) showed good fit. The goodness of fit improved when one topic of digital usage with low factor loading ("I use a wearable.") was removed. Conclusion In Japan, a super-aged society, the trend is almost the same as in Belgium, and DHRQ can be used. The introduction of digital cardiology needs to be individualized, paying attention to age, education level (the higher the better), and smartphone ownership (but not dependent on income).