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Sean Owen Hansen, Nita Valikodath, Sophia Wang, Paula Anne Newman-Casey, Thellea K Leveque, Paul P Lee, Maria A Woodward; Attitudes Towards Telemedicine in Ophthalmology. Invest. Ophthalmol. Vis. Sci. 2016;57(12):6342.
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© ARVO (1962-2015); The Authors (2016-present)
Telemedicine is a novel care delivery pathway to leverage technology to expedite local care. However, patients may have concerns about getting health care in a new way. We evaluated patients’ attitudes towards telemedicine for diabetic retinopathy.
Diabetic patients responded to a survey about telemedicine in a university and Veteran’s Administration primary care and endocrine clinic settings. Content validity was assessed with patients and providers prior to study implementation. The main outcome measures were: 1) “I would be willing to receive my exams this way” (Willingness); 2) I believe this method of eye exam would be more convenient than going to a separate eye appointment” (Convenience); and 3) I would miss interacting with my eye doctor in person.” (Relationship). Participants reported demographic information and systemic or ocular comorbidities. They also reported on their current ease of accessing healthcare. Univariable and multivariable logistic regression was used to report adjusted odds ratios (OR) and 95% confidence intervals (CI).
97 participants completed the survey. Demographic factors including age, sex, race, and education level were not associated with any of the primary outcome measures (willingness, convenience, relationship, p>0.05). For each additional year of having diabetes mellitus, there was a 5% decreased odds of willingness to accept telemedicine compared to standard care (OR=0.95 [CI 0.91-0.99]). For every additional ophthalmologic comorbidity, participants had 68% decreased odds of perceiving telemedicine to be more convenient than standard care (OR=0.32, [CI=0.15-0.71]). For every additional marker of better general access to care, participants had 20% decreased odds of reporting telemedicine to be more convenient than standard care (OR=0.8, [CI=0.68-0.93]). In univariable analyses, but not multivariate analyses, patients with more systemic or ocular comorbidities were more likely to miss interacting with their eye doctor.
Patients with long-standing diabetes are less willing to participate in telemedicine. Patients with ocular or systemic comorbidities, who may visit medical centers frequently, and those with good access to health care are less likely to find telemedicine convenient. Telemedicine programs should target patients who do not have long-standing relationships with eye doctors, who do not go to health care facilities frequently, or who have poor access to care.
This is an abstract that was submitted for the 2016 ARVO Annual Meeting, held in Seattle, Wash., May 1-5, 2016.
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