Digital Health Tools and Patients With Drug Use Disorders: Qualitative Patient Experience Study of the Electronic Case-Finding and Help Assessment Tool (eCHAT) (Preprint)

Background:
One of the promises of ehealth is to better engage patients and improve care for vulnerable populations. One example of a vulnerable population is patients with drug use disorders, who often do not receive the care they need, both for their drug use disorders, as well as their other healthcare needs. Appropriate primary care for patients with drug use disorders needs to be patient-centred, holistic, highly accessible and engaging in understanding the patient experience of this population. The electronic Case-finding and Help Assessment Tool was designed as a patient-centred tool, for the identification and measurement of problematic health behaviours and mood states.

Objective:
The aim of this study was to explore the patient experience of the ‘electronic Case-finding and Help Assessment Tool’ (eCHAT) at an Australian family medicine clinic for patients with drug use disorders.

Methods:
12 semi-structured interviews were conducted with patients, two interviews were conducted with doctors and one focus group with ex-patient advocates. The transcripts were analysed using inductive thematic analysis.

Results:
The key themes were: 1) eCHAT helped reduce stigma related to drug use in the doctor-patient consultation, 2) restricted answer options impacted the ability of patients to tell their stories, 3) patient-related response factors, 4) increased efficiency in the consultation process and, 5) divergence in level of concern around security and privacy.

Conclusions:
eCHAT has the potential to help vulnerable patients in primary care to engage more with their doctors and reduce stigma experiences. eCHAT may be a useful ehealth intervention in a family medicine clinic for patients with drug use disorders. It has the potential to improve patient engagement and access to healthcare, which are crucial areas of need in this vulnerable population. However, it is important to clearly communicate potential privacy risks and how eCHAT should add value to, rather than displace, consultations with the family doctor.