JMIR Publications

ABSTRACT

Background:

Telehealth can improve access to care for people living with multiple sclerosis (pwMS), but information on its acceptance is limited in Switzerland.

Objective:

This study aimed to determine the proportion of pwMS willing to accept telehealth as a new default and the factors associated with their acceptance.

Methods:

We conducted a cross-sectional analysis using survey data from the Swiss Multiple Sclerosis Registry. We defined "telehealth as a default" as a healthcare model where remote consultations (telephone and/or video calls) are the primary mode of interaction between patients and their physicians, with in-person visits based on clinical necessity. Multivariable logistic regression was performed to evaluate the association between telehealth acceptance and socio-demographic and health-related factors. Telehealth acceptance was described in relation to three survey variables that mirrored key constructs from the non-adoption and abandonment of technologies by individuals and the challenges to scale-up, spread, and sustainability of technologies in health and care organisations (NASSS) framework. The variables were digital communication preferences, internet use for health provider searches, and experience with telemedicine.

Results:

Among 427 respondents, 15.5% (66/427) reported a willingness to accept telehealth as a default. In this group, only 21.2% (14/66) had experience using telemedicine. A descriptive analysis of our three NASSS-derived key constructs showed that among the 78.5%(335/427) respondents who generally agreed to digital access to health data, only 17.0% (57/335) accepted telehealth as a default. Notably, 30.7%(129/427) of participants stated a wish for support for using devices or the internet. Among those 129 individuals, 17.1% (22/129) were willing to accept telehealth as a default. Of the 89 people with prior telehealth experience, 15.7% (14/89) were willing to accept telehealth. In multivariable analysis, digital communication with healthcare providers (HCP) (adjusted odds ratio (aOR): 14.56, 95% confidence interval (CI): 6.18 – 39.04, P < .01), current internet use for healthcare provider search (aOR: 7.78, 95% CI: 1.34– 45.32, P = .02) and a secondary progressive MS (SPMS) diagnosis (aOR: 0.23, 95% CI: 0.05–0.07, P= .02) were independently associated with accepting telehealth as a default.

Conclusions:

Our findings suggest a low acceptance of telehealth as a default among pwMS in Switzerland. While our three postulated NASSS-derived key constructs were not associated with telehealth acceptance, we noted additional behavioural factors, including previous digital communication with healthcare providers and using the Internet to search for healthcare provider information, which were associated with telehealth acceptance. Moreover, advanced disease states like SPMS were negatively associated with telehealth acceptance. Thus, telehealth as a default will be most acceptable in pwMS who already use the internet for their health, and those with less severe disease. Future research should explore provider perspectives and evaluate long-term strategies for the acceptance of telehealth in MS care.