Background: Digital health technology is proposed as a valuable tool to support and optimise the management of patients with chronic respiratory diseases (CRD). It is recognised that commencement and usage can vary significantly between patients, however reasons for this remain poorly understood.

Aims: To identify the barriers to digital usage for those with CRD and explore predictors of digital confidence at a UK teaching hospital.

Methods: Single centre prospective study; consecutive patients attending COPD or ILD outpatient clinics were approached to complete a structured questionnaire assessing digital confidence and barriers to digital usage.

Results: 114 questionnaires were completed from Sept to Dec 2022. 82.5% of participants had at least one piece of technology. 53.5% reported low confidence online; this group had less technology than those with higher confidence (p=0.007). In those with low confidence, the most common barriers to go online were nervousness using new technology (11.5%), concern regarding fraud (11.5%) or not having help (9.8%). Age was a strong predictor of digital confidence. Those <71 were more confident (p=0.047), needed less help online (p=0.005) and showed higher preference for online services (p=0.029). Education more weakly predicted digital confidence; those with greater educational attainment were more confident (p=0.011) however there was no difference in technology ownership, need for help or online service preference.

Conclusions: Digital confidence is low in the majority of CRD patients reviewed. Developing targeted approaches to increase online engagement and education is required to successfully adopt digital health technology into this patient groups management.