Perceptions of Telehealth vs In-Person Visits Among Older Adults With Advanced Kidney Disease, Care Partners, and Clinicians

Ladin, Keren; Porteny, Thalia; Perugini, Julia M.; Gonzales, Kristina M.; Aufort, Kate E.; Levine, Sarah; Wong, John B.; Isakova, Tamara; Rifkin, Dena E.; Gordon, Elisa J.; Rossi, Ana P.; Koch‐Weser, Susan; Weiner, Daniel E.

doi:10.1001/jamanetworkopen.2021.37193

Cited by 88 publications

(101 citation statements)

References 40 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…Potential solutions to mitigate these disparities include engaging care partners, investment in technology/internet, and use of telemedicine to supplement rather than supplant in‐person visits. 14 Distribution of video‐enabled tablets have previously been shown to significantly improve preference for telemedicine visits among veterans. 15 Studies examining the impact of implementation of these strategies in transplant patients and the overall population are sorely needed and may identify effective interventions to improve the accessibility and perception of telemedicine.…”

Section: Discussionmentioning

confidence: 99%

Effect of age and rural residency on perceptions about SARS‐CoV‐2 pandemic and vaccination in kidney transplant recipients

Singh

DeWalle

Tanrıöver

et al. 2022

Transplant Infectious Dis

View full text Add to dashboard Cite

Background Transplant patients have poor outcomes in coronavirus‐disease 2019 (COVID‐19). The pandemic's effects on rural patients’ overall care experience, attitudes to telemedicine, and vaccination are poorly understood. Methods We administered a cross‐sectional survey to adult kidney transplant recipients in central Pennsylvania across four clinical sites between March 29, 2021 and June 2, 2021. We assessed the pandemic's impact on care access, telemedicine experience, attitudes toward preventive measures, vaccination, and variation by sociodemographic variables. Results Survey completion rate was 51% (303/594). Of these, 52.8% were rural residents. The most common impact was use of telemedicine (79.2%). Predominant barriers to telemedicine were lack of video devices (10.9%), perceived complexity (5.6%), and technical issues (5.3%). On a 0–10 Likert scale, the mean positive impression for telemedicine was 7.7; lower for patients with telephone‐only versus video visits (7.0 vs. 8.2; p < .001), and age ≥60 years (7.4 vs. 8.1; p = .01) on univariate analyses. Time/travel savings were commonly identified (115/241, 47.7%) best parts of telemedicine and lack of personal connection (70/166, 42.2%) the worst. Only 68.9% had received any dose of COVID vaccination. The vaccinated group members were older (58.4 vs. 53.5 years; p = .007), and less likely rural (47.8% vs. 65.2%; p = .005). Common themes associated with vaccine hesitancy included concerns about safety (27/59, 46%), perceived lack of data (19/59, 32%), and distrust (17/59, 29%). At least one misconception about the vaccines or COVID‐19 was quoted by 29% of vaccine‐hesitant patients. Conclusions Among respondents, the pandemic significantly impacted healthcare experience, especially in older patients in underserved communities. COVID‐19 vaccination rate was relatively low, driven by misconceptions and lack of trust.

show abstract

Section: Discussionmentioning

confidence: 99%

Effect of age and rural residency on perceptions about SARS‐CoV‐2 pandemic and vaccination in kidney transplant recipients

Singh

DeWalle

Tanrıöver

et al. 2022

Transplant Infectious Dis

View full text Add to dashboard Cite

show abstract

“…The key characteristics of the studies included in the review are summarized in Table 1. Overall, seven studies were included in this review; two focused on the effectiveness of telehealth [21,22], three focused on the experiences of patients and providers [23][24][25], and two focused on the use of telehealth [26,27]. Wong et al [21] conducted a pilot randomized controlled trial whereby they randomized 68 patients to the control arm (n=34) and the intervention arm (n=34).…”

Section: Resultsmentioning

confidence: 99%

Telehealth use and Models for Geriatric Patients Since the COVID-19 Pandemic: A Systematic Review

Ajaz

Bouchama

Khalid

et al. 2022

JAMMR

View full text Add to dashboard Cite

Introduction: The gaps in geriatric care provision has become prominent with the onset of the coronavirus disease 2019 (COVID-19 pandemic). Despite the potential capability of the telehealth model to address the specific needs of geriatric patients, only a few geriatric guidelines have focused on the telehealth model during the pandemic. The following systematic review explores the current evidence of telehealth use and applications in geriatric care, which emerged post the COVID-19 pandemic. Methods: Three databases, including PubMed, Cochrane, and Google Scholar, were searched by three independent reviewers to identify relevant studies. Results: Seven studies were included in this review; two focused on the effectiveness of telehealth, three focused on the experiences of patients and providers, and two focused on the use of telehealth. Telehealth did not underperform compared to traditional care models in terms of self-efficacy, patient convenience, reduction in deferred care, increased efficiency of healthcare delivery, reduced travel issues, and improved health education. However, common challenges were disparities in access in favor of urban, cognitively sound, and younger geriatric patients. Conclusion: The current systematic review reported the latest evidence on telehealth use and access across geriatric care since the onset of the COVID-19 pandemic. Telemedicine is gaining support from literature for being non-inferior to traditional healthcare methods, as observed in our findings.

show abstract

“… 39 , 40 Going forward, older adults should be given a choice of whether they see their PCP in‐person or via telemedicine, especially since older adults with comorbidity and/or those who were non‐White tended to be less satisfied with telemedicine. 41 Others have found that non‐Whites may have heightened concerns about privacy and confidentiality associated with telehealth. 42 In addition, 22% of study participants reported feeling less comfortable bringing up multiple health issues during a telemedicine visit which is concerning for older adults with multimorbidity.…”

Section: Discussionmentioning

confidence: 99%

Older adults' perspectives on primary care telemedicine during the COVID‐19 pandemic

Bhatia

Gilliam

Aliberti

et al. 2022

J American Geriatrics Society

View full text Add to dashboard Cite

Background Prior to the COVID‐19 pandemic there were many barriers to telemedicine primary care for adults ≥65 years including insurance coverage restrictions and having lower digital access and literacy. With the pandemic, insurance coverage broadened and many older adults utilized telemedicine creating an opportunity to learn from their experiences to inform future policy. Methods Between April 2020 and June 2021, we conducted a cross‐sectional multimethod study of English‐speaking, cognitively‐intact, adults ≥65, who had a phone‐only and/or video telemedicine visit with their primary care physician within one large Massachusetts health system (10 different practices) since March 2020. The study questionnaire asked participants their overall satisfaction with telemedicine (7‐point scale) and to compare telemedicine with in‐person care. We used linear regression to examine the association between participants' demographics, Charlson comorbidity score, and survey completion date with their satisfaction score. The questionnaire also included open‐ended questions on perceptions of telemedicine; which were analyzed using qualitative methods. Results Of 278 eligible patients reached, 208 completed the questionnaire; mean age was 74.4 years (±4.4), 61.5% were female, 91.4% were non‐Hispanic White, 64.4% had ≥1 comorbidity, and 47.2% had a phone‐only visit. Regardless of their age, participants reported being satisfied with telemedicine; median score was 6.0 on the 7‐point scale (25th percentile = 5.0 and 75th percentile = 7.0). Non‐Whites satisfaction scores were on average 1 point lower than those of non‐Hispanic Whites ( p = 0.02). Those with comorbidity reported scores that on average were 0.5 points lower than those without comorbidity ( p = 0.07). Overall, 39.5% felt their telemedicine visit was worse than in‐person care; 4.9% thought it was better. Participants appreciated telemedicine's convenience but described frustrating technical challenges. While participants preferred in‐person care, most wanted telemedicine to remain available. Conclusions Adults ≥65 reported being satisfied with primary care telemedicine during the pandemic's first 14 months and wanted telemedicine to remain available.

show abstract

Perceptions of Telehealth vs In-Person Visits Among Older Adults With Advanced Kidney Disease, Care Partners, and Clinicians

Abstract: This qualitative study identifies patient, care partner, and clinicians’ perceptions of the patient-centeredness, benefits, and drawbacks of telehealth compared with in-person visits.

Cited by 88 publications

References 40 publications

Effect of age and rural residency on perceptions about SARS‐CoV‐2 pandemic and vaccination in kidney transplant recipients

Effect of age and rural residency on perceptions about SARS‐CoV‐2 pandemic and vaccination in kidney transplant recipients

Telehealth use and Models for Geriatric Patients Since the COVID-19 Pandemic: A Systematic Review

Older adults' perspectives on primary care telemedicine during the COVID‐19 pandemic

Contact Info

Product

Resources

About