{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,16]],"date-time":"2026-10-16T04:44:11Z","timestamp":1792125851871,"version":"4.4.0"},"reference-count":40,"publisher":"MDPI AG","issue":"4","license":[{"start":{"date-parts":[[2019,2,21]],"date-time":"2019-02-21T00:00:00Z","timestamp":1550707200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["IJERPH"],"abstract":"<jats:p>Alongside the growing number of older persons, the prevalence of chronic diseases is increasing, leading to higher pressure on health care services. eHealth is considered a solution for better and more efficient health care. However, not every patient is able to use eHealth, for several reasons. This study aims to provide an overview of: (1) sociodemographic factors that influence the use of eHealth; and (2) suggest directions for interventions that will improve the use of eHealth in patients with chronic disease. A structured literature review of PubMed, ScienceDirect, Association for Computing Machinery Digital Library (ACMDL), and Cumulative Index to Nursing and Allied Health Literature (CINAHL) was conducted using four sets of keywords: \u201cchronic disease\u201d, \u201ceHealth\u201d, \u201cfactors\u201d, and \u201csuggested interventions\u201d. Qualitative, quantitative, and mixed-method studies were included. Four researchers each assessed quality and extracted data. Twenty-two out of 1639 articles were included. Higher age and lower income, lower education, living alone, and living in rural areas were found to be associated with lower eHealth use. Ethnicity revealed mixed outcomes. Suggested solutions were personalized support, social support, use of different types of Internet devices to deliver eHealth, and involvement of patients in the development of eHealth interventions. It is concluded that eHealth is least used by persons who need it most. Tailored delivery of eHealth is recommended.<\/jats:p>","DOI":"10.3390\/ijerph16040645","type":"journal-article","created":{"date-parts":[[2019,2,22]],"date-time":"2019-02-22T03:49:44Z","timestamp":1550807384000},"page":"645","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":257,"title":["Sociodemographic Factors Influencing the Use of eHealth in People with Chronic Diseases"],"prefix":"10.3390","volume":"16","author":[{"given":"Fabienne","family":"Reiners","sequence":"first","affiliation":[{"name":"School of Allied Health Professions, Fontys University of Applied Science, P.O. Box 347, 5600 AH Eindhoven, The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Janienke","family":"Sturm","sequence":"additional","affiliation":[{"name":"School of HRM and Psychology, Fontys University of Applied Science, P.O. Box 347, 5600 AH Eindhoven, The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lisette J.W.","family":"Bouw","sequence":"additional","affiliation":[{"name":"School of Allied Health Professions, Fontys University of Applied Science, P.O. Box 347, 5600 AH Eindhoven, The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Eveline J.M.","family":"Wouters","sequence":"additional","affiliation":[{"name":"School of Allied Health Professions, Fontys University of Applied Science, P.O. Box 347, 5600 AH Eindhoven, The Netherlands"},{"name":"Department of Tranzo, School of Social and Behavioral Sciences, Tilburg University, P.O. Box 90153, 5000 LE Tilburg, The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2019,2,21]]},"reference":[{"key":"ref_1","unstructured":"World Health Organization (2018, December 05). Noncommunicable Diseases (NCDs) and Mental Health Challenges and Solutions. Available online: https:\/\/www.who.int\/beat-ncds\/en\/."},{"key":"ref_2","unstructured":"United Nations, Department of Economic and Social Affairs (2015). World Population Prospects: The 2015 Revision, Key Findings and Advance Tables, United Nations, Department of Economic and Social Affairs."},{"key":"ref_3","doi-asserted-by":"crossref","unstructured":"Tremmel, M., Gerdtham, U.-G., Nilsson, P., and Saha, S. (2017). Economic burden of obesity: A systematic literature review. Int. J. Environ. Res. Public Health, 14.","DOI":"10.3390\/ijerph14040435"},{"key":"ref_4","doi-asserted-by":"crossref","unstructured":"Gheorghe, A., Griffiths, U., Murphy, A., Legido-Quigley, H., Lamptey, P., and Perel, P. (2018). The economic burden of cardiovascular disease and hypertension in low- and middle-income countries: A systematic review. BMC Public Health, 18.","DOI":"10.1186\/s12889-018-5806-x"},{"key":"ref_5","doi-asserted-by":"crossref","first-page":"781","DOI":"10.1111\/tmi.12487","article-title":"The health system burden of chronic disease care: An estimation of provider costs of selected chronic diseases in Uganda","volume":"20","author":"Settumba","year":"2015","journal-title":"Trop. Med. Int. Health"},{"key":"ref_6","unstructured":"World Health Organization (2018, December 05). Noncommunicable diseases. Available online: https:\/\/www.who.int\/news-room\/fact-sheets\/detail\/noncommunicable-diseases."},{"key":"ref_7","doi-asserted-by":"crossref","first-page":"14","DOI":"10.1186\/2251-6581-12-14","article-title":"Role of self-care in management of diabetes mellitus","volume":"12","author":"Shrivastava","year":"2013","journal-title":"J. Diabetes Metab. Disord."},{"key":"ref_8","doi-asserted-by":"crossref","first-page":"3","DOI":"10.1016\/j.ceh.2018.01.001","article-title":"From chronic disease management to person-centered eHealth; A review on the necessity for blended care","volume":"1","author":"Verdijk","year":"2018","journal-title":"Clin. eHealth"},{"key":"ref_9","doi-asserted-by":"crossref","first-page":"e8","DOI":"10.2196\/jmir.5.2.e8","article-title":"Internet-based patient self-care: The next generation of health care delivery","volume":"5","year":"2003","journal-title":"J. Med. Internet Res."},{"key":"ref_10","doi-asserted-by":"crossref","first-page":"e23","DOI":"10.2196\/jmir.1286","article-title":"Effectiveness of web-based interventions on patient empowerment: A systematic review and meta-analysis","volume":"12","author":"Samoocha","year":"2010","journal-title":"J. Med. Internet Res."},{"key":"ref_11","doi-asserted-by":"crossref","unstructured":"Murray, E., Burns, J., See Tai, S., Lai, R., and Nazareth, I. (2005). Interactive health communication applications for people with chronic disease. Cochrane Database Syst. Rev., 4.","DOI":"10.1002\/14651858.CD004274.pub4"},{"key":"ref_12","doi-asserted-by":"crossref","first-page":"e10801","DOI":"10.2196\/10801","article-title":"Usefulness and relevance of an eHealth tool in supporting the self-management of chronic obstructive pulmonary disease: Explorative qualitative study of a cocreative process","volume":"5","author":"Tistad","year":"2018","journal-title":"JMIR Hum. Factors"},{"key":"ref_13","doi-asserted-by":"crossref","first-page":"e35","DOI":"10.2196\/jmir.2439","article-title":"Web 2.0 chronic disease self-management for older adults: A systematic review","volume":"15","author":"Stellefson","year":"2013","journal-title":"J. Med. Internet Res."},{"key":"ref_14","doi-asserted-by":"crossref","first-page":"772","DOI":"10.1097\/MLR.0000000000000560","article-title":"The Digital divide and patient portals: Internet access explained differences in patient portal use for secure messaging by age, race, and income","volume":"54","author":"Graetz","year":"2016","journal-title":"Med. Care"},{"key":"ref_15","doi-asserted-by":"crossref","first-page":"e3268","DOI":"10.7717\/peerj.3268","article-title":"Barriers to the use of personal health records by patients: A structured review","volume":"5","author":"Showell","year":"2017","journal-title":"PeerJ"},{"key":"ref_16","doi-asserted-by":"crossref","unstructured":"Moher, D., Liberati, A., Tetzlaff, J., and Altman, D.G. (2009). Preferred reporting items for systematic reviews and meta-analyses: The PRISMA Statement. PLoS Med., 6.","DOI":"10.1371\/journal.pmed.1000097"},{"key":"ref_17","unstructured":"Hong, Q., Pluye, P., F\u00e0bregues, S., Bartlett, G., Boardman, F., Cargo, M., Dagenais, P., Gagnon, M.-P., Griffiths, F., and Nicolau, B. (2018). Mixed Methods Appraisal Tool (MMAT), Version 2018, McGill."},{"key":"ref_18","doi-asserted-by":"crossref","first-page":"967","DOI":"10.1016\/j.ijmedinf.2014.08.011","article-title":"Knowledge, use and attitude toward eHealth among patients with chronic lung diseases","volume":"83","author":"Hofstede","year":"2014","journal-title":"Int. J. Med. Inform."},{"key":"ref_19","doi-asserted-by":"crossref","first-page":"e32","DOI":"10.2196\/mhealth.4730","article-title":"Uptake of a consumer-focused mHealth application for the assessment and prevention of heart disease: The <30 days study","volume":"4","author":"Goyal","year":"2016","journal-title":"JMIR mHealth uHealth"},{"key":"ref_20","doi-asserted-by":"crossref","unstructured":"Kamis, K., Janevic, M.R., Marinec, N., Jantz, R., Valverde, H., and Piette, J.D. (2015). A study of mobile phone use among patients with noncommunicable diseases in La Paz, Bolivia: Implications for mHealth research and development. Glob. Health, 11.","DOI":"10.1186\/s12992-015-0115-y"},{"key":"ref_21","doi-asserted-by":"crossref","first-page":"427","DOI":"10.1080\/00325481.2016.1170580","article-title":"mHealth intervention to improve medication management in chronically ill patients: Analysis of the recruitment process","volume":"128","year":"2016","journal-title":"Postgrad. Med."},{"key":"ref_22","doi-asserted-by":"crossref","unstructured":"Duplaga, M. (2015). A cross-sectional study assessing determinants of the attitude to the introduction of eHealth services among patients suffering from chronic conditions. BMC Med. Inform. Decis. Mak., 15.","DOI":"10.1186\/s12911-015-0157-3"},{"key":"ref_23","doi-asserted-by":"crossref","first-page":"e123","DOI":"10.2196\/jmir.3257","article-title":"Are people with chronic diseases interested in using telehealth? A cross-sectional postal survey","volume":"16","author":"Edwards","year":"2014","journal-title":"J. Med. Internet Res."},{"key":"ref_24","first-page":"12","article-title":"Disparities in the use of a mHealth medication adherence promotion intervention for low-income adults with type 2 diabetes","volume":"23","author":"Nelson","year":"2016","journal-title":"JAMIA"},{"key":"ref_25","doi-asserted-by":"crossref","first-page":"1132","DOI":"10.1016\/j.oraloncology.2015.10.003","article-title":"A prospective study of electronic quality of life assessment using tablet devices during and after treatment of head and neck cancers","volume":"51","author":"Pollom","year":"2015","journal-title":"Oral Oncol."},{"key":"ref_26","first-page":"44","article-title":"Are Malaysian diabetic patients ready to use the new generation of health care service delivery? A telehealth interest assessment","volume":"23","author":"Samiei","year":"2016","journal-title":"Malays. J. Med. Sci."},{"key":"ref_27","doi-asserted-by":"crossref","first-page":"e009367","DOI":"10.1136\/bmjopen-2015-009367","article-title":"Potential for the use of mHealth in the management of cardiovascular disease in Kerala: A qualitative study","volume":"5","author":"Smith","year":"2015","journal-title":"BMJ Open"},{"key":"ref_28","doi-asserted-by":"crossref","first-page":"e13","DOI":"10.2196\/cancer.5711","article-title":"EHealth acceptance and new media preferences for therapy assistance among breast cancer patients","volume":"2","author":"Drewes","year":"2016","journal-title":"JMIR Cancer"},{"key":"ref_29","doi-asserted-by":"crossref","first-page":"185","DOI":"10.1016\/j.jgo.2013.11.001","article-title":"Age-related trends in utilization of the internet and electronic communication devices for coordination of cancer care in elderly patients","volume":"5","author":"Saied","year":"2014","journal-title":"J. Geriatr. Oncol."},{"key":"ref_30","doi-asserted-by":"crossref","unstructured":"Tersch\u00fcren, C., Mensing, M., and Mekel, O.C. (2012). Is telemonitoring an option against shortage of physicians in rural regions? Attitude towards telemedical devices in the North Rhine-Westphalian health survey, Germany. BMC Health Serv. Res., 12.","DOI":"10.1186\/1472-6963-12-95"},{"key":"ref_31","doi-asserted-by":"crossref","first-page":"1","DOI":"10.2196\/jmir.2170","article-title":"Type 1 diabetes ehealth psychoeducation: Youth recruitment, participation, and satisfaction","volume":"15","author":"Whittemore","year":"2013","journal-title":"J. Med. Internet Res."},{"key":"ref_32","doi-asserted-by":"crossref","first-page":"298","DOI":"10.1089\/tmj.2016.0043","article-title":"Compliance patterns and utilization of e-health for glucose monitoring: Standalone internet gateway and tablet device","volume":"23","author":"Rho","year":"2017","journal-title":"Telemed. J. E. Health"},{"key":"ref_33","doi-asserted-by":"crossref","first-page":"219","DOI":"10.1108\/JAT-06-2013-0017","article-title":"What influences withdrawal because of rejection of telehealth \u2013 the whole systems demonstrator evaluation","volume":"7","author":"Rixon","year":"2013","journal-title":"J. Assist. Technol."},{"key":"ref_34","doi-asserted-by":"crossref","first-page":"102","DOI":"10.1016\/j.pec.2007.09.008","article-title":"Preferences for self-management support: Findings from a survey of diabetes patients in safety-net health systems","volume":"70","author":"Sarkar","year":"2008","journal-title":"Patient Educ. Couns."},{"key":"ref_35","first-page":"225","article-title":"eHealth literacy and partner involvement in treatment decision making for men with newly diagnosed localized prostate cancer","volume":"44","author":"Song","year":"2017","journal-title":"Oncol. Nurs. Forum"},{"key":"ref_36","doi-asserted-by":"crossref","first-page":"e175","DOI":"10.2196\/jmir.2425","article-title":"Use of a Web 2.0 Portal to improve education and communication in young patients with families: Randomized controlled trial","volume":"15","author":"Hanberger","year":"2013","journal-title":"J. Med. Internet Res."},{"key":"ref_37","first-page":"30","article-title":"Professional practice and innovation: Chronic disease, geographic location and socioeconomic disadvantage as obstacles to equitable access to e-Health","volume":"39","author":"Han","year":"2010","journal-title":"Health Inf. Manag. J."},{"key":"ref_38","doi-asserted-by":"crossref","first-page":"1","DOI":"10.2196\/jmir.7981","article-title":"Examining internet and eHealth practices and preferences: Survey study of australian older adults with subjective memory complaints, mild cognitive impairment, or dementia","volume":"19","author":"LaMonica","year":"2017","journal-title":"J. Med. Internet Res."},{"key":"ref_39","doi-asserted-by":"crossref","first-page":"1","DOI":"10.1145\/3274347","article-title":"MyPath: Investigating breast cancer patients\u2019 use of personalized health information","volume":"2","author":"Jacobs","year":"2018","journal-title":"Proc. ACM Hum. Comput. Interact."},{"key":"ref_40","doi-asserted-by":"crossref","unstructured":"Van Deursen, A.J.A.M., and Helsper, E.J. (2015). The third-level digital divide: Who benefits most from being online?. Com. Inform. Technol. Annual, 29\u201352.","DOI":"10.1108\/S2050-206020150000010002"}],"container-title":["International Journal of Environmental Research and Public Health"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/1660-4601\/16\/4\/645\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,10,11]],"date-time":"2025-10-11T12:33:56Z","timestamp":1760186036000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/1660-4601\/16\/4\/645"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2019,2,21]]},"references-count":40,"journal-issue":{"issue":"4","published-online":{"date-parts":[[2019,2]]}},"alternative-id":["ijerph16040645"],"URL":"https:\/\/doi.org\/10.3390\/ijerph16040645","relation":{},"ISSN":["1660-4601"],"issn-type":[{"value":"1660-4601","type":"electronic"}],"subject":[],"published":{"date-parts":[[2019,2,21]]}}}