JMIR Publications

ABSTRACT

Background:

Previous studies have demonstrated telemedicine (TM) to be an effective tool to complement rheumatology care and address workforce shortage. With the outbreak of the SARS-CoV-2 pandemic, TM experienced a massive upswing. A previous study revealed that physicians’ willingness and actual use are closely connected to knowledge on TM. Yet, it is still unclear which factors are associated with patients’ motivation to use TM.

Objective:

The study aimed to identify factors that determine patients’ willingness to try TM (TM-try) and their wish that rheumatologists offer TM services (TM-wish).

Methods:

We conducted a secondary analysis of data from a nationwide cross-sectional survey with RMD-patients. Bayesian univariate and multivariate logistic regression analyses were applied to the data in order to determine which factors were associated with TM-try and TM-wish. Predictor variables (covariates) studied individually included sociodemographic factors (e.g., age, sex) and health characteristics (e.g., disease type, health status). All the variables positively and negatively associated with TM-try/TM-wish in the univariate analyses were then considered for Bayesian model averaging analysis (BMA) after a selection based on the variance inflation factor (≤ 2.5). All analyses were stratified by sex.

Results:

A total of 59 and 45 variables/factors (out of 102) were found to be positively or negatively associated (ROPE% ≤ 5%) with TM-try and TM-wish, respectively. A total of 16 and 8 determinant factors were identified for TM-try and TM-wish, respectively. Wishing that TM services were offered by rheumatologists, having internet access at home, being 5-10 km from the GP’s office, owning an electronic device and being age 40 to 60 years were among the factors positively associated with TM-try/TM-wish. By contrast, not being yet diagnosed with RMD, having no prior knowledge of TM, having a bad health status, living in rural area, not documenting one’s health status, not owning an electronic device and being aged 60-80 years old were negatively associated with TM-try/TM-wish.

Conclusions:

Our results suggest that health status, knowledge, age, and access to technical equipment and infrastructure influence RMD patients' motivation to use telehealth. In particular, older RMD patients living in rural areas, that could likely benefit from using TM, are currently not motivated and seem to need additional TM support.