Background: Current evidence supports telehealth as a promising approach to increasing access to care and improving patient outcomes. However, provider and patient perspectives on telehealth can influence engagement with interventions and may impact health behavior and clinical outcomes for better or worse. Prior studies have focused mainly on the views of healthcare providers (HCPs). More research is needed on patients’ perspectives in order to better understand how their perceptions influence use of telehealth, subsequent health behaviors, and clinical outcomes. Therefore the purpose of this study was to explore patients’ experiences, perspectives, and attitudes related to telehealth. The theoretical framework guiding this research posits that patient adherence to self-care activities is influenced by patient perceptions about participation in the healthcare encounter, self-efficacy, and understanding of healthcare provider recommendations. Telehealth interventions may reinforce these factors, thereby supporting improved adherence to self-care regimens and improved clinical outcomes.
Methods: Data for this study were collected from 16 attention control group participants enrolled within a larger study that tested an intervention for promoting lifestyle changes for cardiovascular disease risk factor reduction in adults with type 2 diabetes mellitus (T2DM). The intervention group received biweekly decision coaching based on self-selected health goals, while the attention control group received general healthcare information phone calls at the same interval. Telehealth was the topic of one of the healthcare information phone calls, and participants’ self-reported experiences were written into case notes summarizing the key content of the dialog. Data were then coded for key themes and content-analyzed in relation to selected socio-demographic and clinical variables. Bivariate correlational statistics and chi-square tests of significance were used in the applicable contexts to explore associations among the variables.
Results: Four major topics emerged from dialog of participants during the phone calls: (1) types of telehealth services used, (2) reasons for using telehealth, (3) factors that facilitated telehealth use, and, (4) factors that were barriers to telehealth use. Three statistically significant relationships were found between clinical variables and telehealth perceptions. First, time (years) since diagnosis with T2DM was correlated with higher HbA1C levels at baseline (r=0.51, p=0.04), indicating lower T2DM control with longer time since diagnosis. Time since diagnosis with T2DM was also associated with a higher number of perceived facilitators of telehealth use (r=0.58, p=0.02). Finally, an increased number of reasons to use telehealth (r=0.71, p=0.002) and a higher number of perceived facilitators (r=0.76, p=0.001) were correlated with current telehealth use.
Discussion: For telehealth interventions to be successful, healthcare providers should understand what purposes, facilitators, and barriers are relevant to their patients. HCPs should also consider patients with complex medical conditions as potential candidates for telehealth interventions. This study contributes to an emerging body of research on patients’ perceptions of telehealth. This new knowledge is a necessary basis to inform future research on the impact of telehealth in management of chronic health conditions such as T2DM.No embargoAcademic Major: Nursin
