Exploring how the design and provision of digital self-management technology can improve the uptake by older adults with chronic kidney disease, diabetes and dementia: A modified e-Delphi study

Louise Moody, Esme Wood, Abigail Needham, Andrew Booth, Wendy Tindale

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Abstract

Objectives: As development and introduction of digital self-management technologies continues to increase, the gap between those who can benefit, and those who cannot correspondingly widens. This research aimed to explore the use of digital self-management technology by older adults with three highly-prevalent long-term conditions (chronic kidney disease, diabetes and dementia), and build expert consensus across the conditions on changes needed to improve effective usage.

Method: This qualitative research involved a modified e-Delphi Study. The Delphi panel was comprised of experts with personal, academic or clinical expertise related to one of the long-term conditions and/or the development and use of digital self-management technology. The e-Delphi involved a round of online semi-structured interviews followed by two rounds of a structured online survey.

Results: Fourteen experts participated in the study, with eleven of the fourteen completing all three rounds. Analysis of the interviews (round 1 of the Delphi) led to 7 main themes and 29 sub-themes. These were translated into 26 statements that formed the basis of the online survey questions. In the first administration of the survey (round 2) 19 statements reached consensus. After the second administration a further 6 statements reach consensus.

Conclusion: The findings reflect expert consensus on barriers to the use of digital self-management by older adults with 3 different, but inter-related conditions, and identify ways in which the design and provision of such technologies could be improved to facilitate more effective use. It is concluded that both the design and the provision of technologies should consider a combination of individual, condition-specific and age-related requirements. By building a consensus on issues and potential strategies common across the three conditions, we aim to inform future research and practice and facilitate effective self-management by older adults.
Original languageEnglish
Number of pages16
JournalDigital Health
Volume10
DOIs
Publication statusPublished - 7 Jun 2024

Bibliographical note

This article is distributed under the terms of the Creative Commons Attribution 4.0 License (https://creativecommons.org/licenses/by/4.0/) which permits any use, reproduction and distribution of the work without further permission provided the original work is attributed as specified on the SAGE and Open Access page (https://us.sagepub.com/en-us/nam/open-access-at-sage).

Funder

The author(s) disclosed receipt of the following financial support for the research, authorship, and/or publication of this article: The research and Dr Esme Wood's time was supported by the Abbeyfield Research Foundation. Tindale 2020-21. 'Identifying individual enablers and barriers to the use of digital technology for the self-management of long-term conditions by older adults: a meta-ethnographic study' The research reported in this publication was also supported by the National Institute for Health Research (NIHR). Professor Wendy Tindale is the Clinical Director, Professor Louise Moody is a Theme Lead, and Abigail Needham is a Project Manager for the NIHR Devices for Dignity MedTech Cooperative. The views expressed are those of the authors and not necessarily those of the NHS, the NIHR or the Department of Health and Social Care. Andrew Booth's time and methodological input was funded by the University of Sheffield.

Keywords

  • Digital technology
  • self-management
  • older adults
  • diabetes
  • chronic kidney disease
  • dementia

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