Digital Health Literacy and Attitudes Toward eHealth Technologies Among Patients With Cardiovascular Disease and Their Implications for Secondary Prevention: Survey Study.

Background: Cardiovascular disease is the major cause of death worldwide, leading to a significant socioeconomic burden. Although secondary prevention is a cornerstone in chronic disease management, adherence to guideline recommendations in this regard often falters, leading to suboptimal outcomes. While eHealth technologies are promising for improving treatment adherence, they also represent a new approach to secondary prevention. However, a common critique is that extensive digitalization may not adequately address the needs of older adults with chronic medical conditions. Objective: This study aims to analyze eHealth literacy, digital use patterns, and general attitudes toward digital technologies in a collective of patients with cardiovascular disease to identify potential obstacles in implementing mobile health technologies in secondary preventive therapy. Methods: This survey-based study was a part of the baseline examination of the PreventiPlaque trial. It involved 240 participants with known coronary artery disease. The assessment evaluated their current understanding of the general use of digital devices. The questionnaire covered aspects such as the duration of daily use, personal attitudes, and the perceived burden associated with digital media. eHealth literacy was assessed within the target population and general demographic data were gathered, focusing on cardiovascular comorbidities and risk factors. Results: The analysis revealed an average age of 61.9 (SD 8.9) years, with 59.9% (n=144) of the participants being male. Overall, 37.3% (n=90) of the participants had previous knowledge of digital health interventions, while only 17.8% (n=41) had used them. Despite the generally low practical application within this study population, there was a high level of confidence in handling digital devices, with 61.9% (n=149) expressing themselves as either rather confident or very confident. Regarding the levels of eHealth literacy among the participants, 71.2% (n=170) claimed to be familiar with locating health information on the internet, and 64% (n=153) of participants felt capable of critically evaluating its quality. These levels of digital confidence were consistent across all age groups. Moreover, internet use rates remained high even among the older participants, with 80% (n=192) of those participants older than 75 years using the internet for 1-3 hours a day. Conclusions: The study unveiled a notable confidence level among participants regarding the use of digital devices, coupled with a favorable attitude toward digital media evident across all age brackets. Remarkably, internet use rates remained high, even among older participants. The actual utilization of digital health interventions was relatively low, potentially stemming from challenges in locating reliable sources. These findings emphasize the prospect of future eHealth interventions customized to the distinct needs and preferences of patients in cardiovascular disease management. Recognizing the incongruity between confidence in device use and the restricted adoption of digital health tools can guide the development of focused interventions to narrow this divide.