Ann Arbor VA Healthcare System, Ann Arbor, Michigan, USA.
Telemed J E Health. 2010 Dec;16(10):1030-41. doi: 10.1089/tmj.2010.0074. Epub 2010 Nov 10.
patients in underdeveloped countries may be left behind by advances in telehealthcare. We surveyed chronically ill patients with low incomes in Honduras to measure their use of mobile technologies and willingness to participate in mobile disease management support.
624 chronically ill primary care patients in Honduras were surveyed. We examined variation in telephone access across groups defined by patients' sociodemographic characteristics, diagnoses, and access to care. Logistic regression was used to identify independent correlates of patients' interest in automated telephonic support for disease management.
participants had limited education (mean 4.8 years), and 65% were unemployed. Eighty-four percent had telephone access, and 78% had cell phones. Most respondents had voicemail (61%) and text messaging (58%). Mobile technologies were particularly common among patients who had to forego clinic visits and medications due to cost concerns (each p < 0.05). Most patients (>80%) reported that they would be willing to receive automated calls focused on appointment reminders, medication adherence, health status monitoring, and self-care education. Patients were more likely to be willing to participate in automated telemedicine services if they had to cancel a clinic appointment due to transportation problems or forego medication due to cost pressures.
even in this poor region of Honduras, most chronically ill patients have access to mobile technology, and most are willing to participate in automated telephone disease management support. Given barriers to in-person care, new models of mobile healthcare should be developed for chronically ill patients in developing countries.
在医疗保健技术取得进步的情况下,欠发达国家的患者可能会被抛在后面。我们调查了洪都拉斯收入较低的慢性病患者,以衡量他们使用移动技术的情况以及参与移动疾病管理支持的意愿。
对洪都拉斯的 624 名慢性病初级保健患者进行了调查。我们根据患者的社会人口统计学特征、诊断和获得医疗服务的情况,研究了电话访问的差异。使用逻辑回归来确定患者对自动化电话疾病管理支持的兴趣的独立相关因素。
参与者的受教育程度有限(平均 4.8 年),65%的人失业。84%的人有电话访问,78%的人有手机。大多数受访者有语音信箱(61%)和短信(58%)。移动技术在因费用问题不得不放弃就诊和药物治疗的患者中特别常见(均 p < 0.05)。大多数患者(>80%)表示,他们愿意接受关注预约提醒、药物依从性、健康状况监测和自我保健教育的自动电话。如果由于交通问题取消预约或由于费用压力而放弃药物治疗,患者更有可能愿意参与自动远程医疗服务。
即使在洪都拉斯这个贫困地区,大多数慢性病患者都能使用移动技术,而且大多数人都愿意参与自动电话疾病管理支持。鉴于面对面护理的障碍,应该为发展中国家的慢性病患者开发新的移动医疗保健模式。