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Research article
Adolescent and Caregiver Attitudes Towards Telemedicine Use in Pediatric Nephrology
Guido Filler
Children's Hospital, London Health Science Centre
Corresponding Author
ORCiD: https://orcid.org/0000-0003-1891-6765
License:
This work is licensed under a CC BY 4.0 License. Read Full License
Background: Telemedicine is increasingly utilized as an alternative to in person consultation. Current pandemic conditions are providing additional impetus to virtual care delivery. We aimed at comparing both pediatric patient and caregiver attitudes towards telemedicine (here as tertiary center to remote health care location) as a crucial determinant of longer-term effectiveness.
Methods: This mixed methods cohort study combined patient characteristics and analysis of transcribed structured telephone interviews with both pediatric nephrology patients (11-18 years) and their caregivers.
Results: For 11 child-parent dyads, the median distances to tertiary center were 191 km (range 110-1378 km) and 1 km (1-54 km) to remote telemedicine location. Overall a ratio of 2:1 for telemedicine to in-person visits was favored; with caregivers more in favor of remote care than patients. Qualitative analysis found that experiences with telemedicine were distinguished by consultation-specific factors and contextual factors. Contextual factors (travel/cost savings) were valued for telemedicine by patients and caregivers. Consultation-specific factors, such as the ability to show the doctor physical symptoms, were more valued during in-person consultations, especially by patients. The overall visit type preference was related to the nature of the consultation. For regular check-ups, and for patients with less complex needs, participants felt that telemedicine offered a comparable experience to in-person visits.
Conclusions: Indiscriminate transfer to chronic care predicated on mainly telemedicine approach is not compatible with user expressed attitudes (especially patients). Accurately mapping models of care to these attitudes is an essential determinant of effective management and longer-term engagement with potentially life-long health challenges.
Keywords
Caregiver attitudes, adolescent patient attitudes, telemedicine, clinic visits, travel distance
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Peer Review Timeline
CURRENT STATUS: Under Review
Version 1
Posted 21 Sep, 2020
No community comments so far
Reviewer #2 agreed
On 17 Dec, 2020
Review #1 received
Received 15 Nov, 2020
Reviewer #1 agreed
On 23 Oct, 2020
Reviewers invited
Invitations sent on 22 Sep, 2020
Editor assigned
On 15 Sep, 2020
Submission checks complete
On 14 Sep, 2020
Editor invited
On 14 Sep, 2020
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Posted 07 Aug, 2020
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This preprint is under consideration at BMC Health Services Research. A preprint is a preliminary version of a manuscript that has not completed peer review at a journal. Research Square does not conduct peer review prior to posting preprints. The posting of a preprint on this server should not be interpreted as an endorsement of its validity or suitability for dissemination as established information or for guiding clinical practice.
Learn more about In Review
Research article
Adolescent and Caregiver Attitudes Towards Telemedicine Use in Pediatric Nephrology
Guido Filler
Children's Hospital, London Health Science Centre
Corresponding Author
ORCiD: https://orcid.org/0000-0003-1891-6765
Badges
Prescreen
This manuscript passed our Prescreen assessment
Complete author information
Appropriate declaration statements
Potential risks to human health
Prescreen
Peer Review Timeline
CURRENT STATUS: Under Review
Version 1
Posted 21 Sep, 2020
No community comments so far
Reviewer #2 agreed
On 17 Dec, 2020
Review #1 received
Received 15 Nov, 2020
Reviewer #1 agreed
On 23 Oct, 2020
Reviewers invited
Invitations sent on 22 Sep, 2020
Editor assigned
On 15 Sep, 2020
Submission checks complete
On 14 Sep, 2020
Editor invited
On 14 Sep, 2020
Version (no preprint)
Posted 07 Aug, 2020
This version was not preprinted
Metrics
Comments: 0
PDF Downloads: ...
HTML Views: ...
License:
This work is licensed under a CC BY 4.0 License. Read Full License
Background: Telemedicine is increasingly utilized as an alternative to in person consultation. Current pandemic conditions are providing additional impetus to virtual care delivery. We aimed at comparing both pediatric patient and caregiver attitudes towards telemedicine (here as tertiary center to remote health care location) as a crucial determinant of longer-term effectiveness.
Methods: This mixed methods cohort study combined patient characteristics and analysis of transcribed structured telephone interviews with both pediatric nephrology patients (11-18 years) and their caregivers.
Results: For 11 child-parent dyads, the median distances to tertiary center were 191 km (range 110-1378 km) and 1 km (1-54 km) to remote telemedicine location. Overall a ratio of 2:1 for telemedicine to in-person visits was favored; with caregivers more in favor of remote care than patients. Qualitative analysis found that experiences with telemedicine were distinguished by consultation-specific factors and contextual factors. Contextual factors (travel/cost savings) were valued for telemedicine by patients and caregivers. Consultation-specific factors, such as the ability to show the doctor physical symptoms, were more valued during in-person consultations, especially by patients. The overall visit type preference was related to the nature of the consultation. For regular check-ups, and for patients with less complex needs, participants felt that telemedicine offered a comparable experience to in-person visits.
Conclusions: Indiscriminate transfer to chronic care predicated on mainly telemedicine approach is not compatible with user expressed attitudes (especially patients). Accurately mapping models of care to these attitudes is an essential determinant of effective management and longer-term engagement with potentially life-long health challenges.