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What patients think about E-health: patients’ perspective on internet-based cognitive behavioral treatment for patients with rheumatoid arthritis and psoriasis


In the past decade, the use of internet-based cognitive behavioral treatments (internet-based CBT) for a wide range of patients has grown intensively. Incorporating the patients’ opinions and perspective into new health care innovations might improve the quality and applicability of these innovations, as high dropout rates and low attrition are the often-reported concerns in E-health research. Most studies to date have examined patient perspectives on specific internet-based interventions that patients had participated in, and not the views of the general public. The current paper explores the perspective of patients with rheumatoid arthritis and psoriasis on internet-based CBT for these patient groups. In total, 100 patients (55 % male) participated in a semi-structured telephone interview about internet-based CBT, including questions about possible advantages and disadvantages and the readiness to participate in this kind of treatment. Most patients (78 %) were prepared to participate in internet-based CBT. Patients endorsed the advantages (57 %) more often than the disadvantages (34 %). The ease of internet-based CBT and the time saved were especially appealing to patients. Main disadvantages according to patients are that not all patients will be reached due to computer illiteracy and the lack of face-to-face interaction with the therapist. The results suggest that, from the patients’ perspective, internet-based CBT is a promising health care development. Further research into aspects such as therapist interaction and enhancing computer literacy might contribute to an effective way of E-health care delivery in the future.

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This research was supported by grants from the Dutch Science Organization ZonMw and Wyeth Pharmaceuticals.

Ethics committee

The regional ethics committee of the Radboud University Nijmegen Medical Centre indicated that there was no approval needed for the protocol of this study.



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Correspondence to Maaike Ferwerda.

Appendix 1

Appendix 1

Short explanation of internet-based CBT at the beginning of the interview with patients.

At this moment we are developing an internet-based treatment for patients with rheumatoid arthritis and psoriasis at the Radboud University Nijmegen Medical Centre. This treatment is aimed at learning to deal with the consequences of the illness for daily life, such as pain and fatigue. We would like to investigate what patients see as important aspects of internet treatments and what they think of several advantages and disadvantages. You could help us gain a better understanding of patients’ perspectives.

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Ferwerda, M., van Beugen, S., van Burik, A. et al. What patients think about E-health: patients’ perspective on internet-based cognitive behavioral treatment for patients with rheumatoid arthritis and psoriasis. Clin Rheumatol 32, 869–873 (2013).

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  • E-health
  • (Internet-based) cognitive behavioral therapy
  • Patient compliance
  • Patient perspective
  • Patient preference