Attitudes towards digital health technology for the care of people with chronic kidney disease: A technology acceptance model exploration

Background: Chronic Kidney Disease (CKD) is a long-term condition and a major health problem, which affects over 3.5 million adults in the UK. Use of digital technology has been proposed as a means of improving patient management. It is important to understand the factors that affect the acceptability of this technology to people living with chronic kidney disease. This study used the Technology Acceptance Model 3 (TAM) to investigate whether perceived ease of use and perceived usefulness could predict intention behaviour. It then investigated if intention to use digital technology predicted actual use. Methodology: This was a cross-sectional study whereby the TAM3 questionnaire was sent online to people known to have chronic kidney disease via Kidney Care UK. The characteristics of the respondents (age, sex, CKD stage) were recorded. Principal Findings: The questionnaire was sent to 12,399 people, of which 229 (39% drop out) completed it. The respondents’ age ranged from 24–90 years and 45% (n = 102) were male. Thirty-five percent of participants had advanced kidney care, 33% (n = 76) had kidney transplant and 22% (n = 51) had CKD. A multiple regression analysis showed a perceived ease of use and perceived usefulness of the technology predicted behaviour intention to use digital health technology. Behaviour intention did not significantly predict actual use behaviour. Conclusion: Perceived usefulness and perceived ease of use are important factors in determining the intention of people with CKD to use digital healthcare. However, a gap exists between this intention and readiness to actually use the technology. This needs to be overcome if digital healthcare is to gain future traction in the clinical scenario. Author summary: A previously validated online questionnaire (Technology Acceptance Model 3) was used to explore how people with Chronic Kidney Disease (CKD) perceive digital health technology and to assess their attitudes towards its use in the management of their condition. All participants had CKD at various stages of severity or were recipients of a kidney transplant and were receiving specialist care at the Wessex Kidney Centre based in Portsmouth UK. Two-hundred and twenty-nine people aged 24–90 completed the survey. Responses were unaffected by the type of kidney disease or the sex of the respondent. We found that people perceived digital technology to be easier to use if organisational and technical resources were in place to support its use, if they were less anxious and if they enjoyed using it. Participants who reported digital health technology easy were those who also considered it to be highly relevant to their care. Intention to use digital health technology was greater when participants perceived it to be easy to use and useful. This effect was amplified by age, with younger people being more likely to use digital health technology than older people.