Supporting Self-management Through eHealth - Exploring the Needs, Challenges and Solutions in General Practice: A Qualitative and Participatory Design Study

Introduction Digital transformation and integration of eHealth solutions into chronic pain management faces significant challenges that have not yet been met. To realize the potential of eHealth solutions there is a need to understand the challenges, needs and care processes of eHealth into specific contexts and specific purposes. The objective of this study was to explore challenges, barriers, support needs, and visions experienced by patients and general practitioners (GPs) in the context of an eHealth solution designed for chronic pain management in general practice. Methods The study used action-research as a methodological framework. We conducted two future workshops involving eight patients living with chronic pain and seven GPs with clinical experience in managing chronic pain. Through case vignettes and inspiration cards, these workshops stimulated discussions and shared knowledge construction. Data were analysed using reflexive thematic analysis, separated by the groups, and were synthesized via a matrix analysis. Results The analysis revealed five content summary themes: Theme 1—patients’ experience of challenges in life with pain; Theme 2—challenges in treating patients with chronic pain; Theme 3—patients’ suggestions for the structure of the eHealth solution; Theme 4—GP’ suggestions for the structure of the eHealth solution; and Theme 5—differences and similarities: Visions for an eHealth solution. The analysis generated several touchpoints and tension within the patient-physician encounter. Conclusion In conclusion, these themes provide distinct narratives, offering valuable insights into the design objectives. Our study represents a significant advancement in developing personalized and innovative eHealth solutions for general practice, addressing key clinical challenges. Perspective Realizing the potential of eHealth solutions, these findings highlight both contrasting and shared viewpoints on design objectives, providing crucial insight into end-user perspectives for effective pain management. Additionally, the study underscores the importance of supported self-management and clinical communication in understanding each patient’s overall presentation within the healthcare system. ### Competing Interest Statement All authors state no conflict of interest. MSH has received support from non-industrial professional, private, and scientific bodies (reimbursement of travel costs and speaker fees) for lectures on pain, and he receives book royalties from Gyldendal, Munksgaard Denmark, FADL, and Muusmann publications. Otherwise, none of the authors declare conflicts of interest. ### Funding Statement This work is funded by the Foundation for General Practice (Danish: Fonden for Almen Praksis) and Nord-KAP-the Quality Unit for General Practice in The North Denmark Region (Danish: Kvalitetsenheden for Almen Praksis (Nord-KAP)). The funders had no role in the study design, data collection and analysis, decision to publish, or preparation of the manuscript. ### Author Declarations I confirm all relevant ethical guidelines have been followed, and any necessary IRB and/or ethics committee approvals have been obtained. Yes The details of the IRB/oversight body that provided approval or exemption for the research described are given below: This study was deemed exempt from ethical approval by The North Denmark Region Committee on Health Research Ethics due to the non-interventional nature of the study and the data that was collected. Signed informed consent was obtained from all participants. All data were stored on a secure fileshare. I confirm that all necessary patient/participant consent has been obtained and the appropriate institutional forms have been archived, and that any patient/participant/sample identifiers included were not known to anyone (e.g., hospital staff, patients or participants themselves) outside the research group so cannot be used to identify individuals. Yes I understand that all clinical trials and any other prospective interventional studies must be registered with an ICMJE-approved registry, such as ClinicalTrials.gov. I confirm that any such study reported in the manuscript has been registered and the trial registration ID is provided (note: if posting a prospective study registered retrospectively, please provide a statement in the trial ID field explaining why the study was not registered in advance). Yes I have followed all appropriate research reporting guidelines, such as any relevant EQUATOR Network research reporting checklist(s) and other pertinent material, if applicable. Yes Data will be available upon reasonable request to corresponding author.