Zöllner Johann Philipp, Noda Anna H, McCoy Jeannie, Schulz Juliane, Tsalouchidou Panagiota-Eleni, Langenbruch Lisa, Kovac Stjepana, Knake Susanne, von Podewils Felix, Hamacher Mario, Mann Catrin, Leyer Anne-Christine, van Alphen Natascha, Schubert-Bast Susanne, Rosenow Felix, Strzelczyk Adam
Epilepsy Center Frankfurt Rhine-Main, Department of Neurology, University Hospital Frankfurt-Goethe-University, Frankfurt am Main, Germany.
LOEWE Center for Personalized Translational Epilepsy Research, Goethe-University, Frankfurt am Main, Germany.
Telemed J E Health. 2023 Apr;29(4):540-550. doi: 10.1089/tmj.2022.0238. Epub 2022 Aug 18.
Telehealth can improve the treatment of chronic disorders, such as epilepsy. Telehealth prevalence and use increased during the coronavirus disease 2019 (COVID-19) pandemic. However, familiarity with and use of telehealth and health-related mobile applications (apps) by persons with epilepsy remain unknown. We investigated telehealth use, demographics, and clinical variables within the multicenter Epi2020 cross-sectional study. Between October and December 2020, adults with epilepsy completed a validated questionnaire, including individual questions regarding knowledge and use of apps and telehealth. Of 476 included individuals (58.2% women; mean age 40.2 ± 15.4 years), 41.6% reported using health-related apps. Health apps were used more frequently (pedometer 32.1%, exercise app 17.6%) than medical apps (health insurance 15.1%, menstrual apps 12.2%) or apps designed for epilepsy (medication reminders 10.3%, seizure calendars 4.6%). Few used seizure detectors (i.e., apps as medical devices 1.9%) or mobile health devices (fitness bracelet 11.3%). A majority (60.9%) had heard the term telehealth, 78.6% of whom had a positive view. However, only 28.6% had a concrete idea of telehealth, and only 16.6% reported personal experience with telehealth. A majority (55%) would attend a teleconsultation follow-up, and 41.2% would in a medical emergency. Data privacy and availability were considered equally important by 50.8%, 21.8% considered data privacy more important, and 20.2% considered data availability more important. Current health-related app use was independently associated with younger age ( = 0.003), higher education ( < 0.001), and subjective COVID-19-related challenges ( = 0.002). Persistent seizure occurrence (vs. seizure freedom ≥12 months) did not affect willingness to use teleconsultations on multivariable logistic regression analysis. Despite positive telehealth views, few persons with epilepsy in Germany are familiar with specific apps or services. Socioeconomic factors influence telehealth use more than baseline epilepsy characteristics. Telehealth education and services should target socioeconomically disadvantaged individuals to reduce the digital care gap. German Clinical Trials Register (DRKS00022024; Universal Trial Number: U1111-1252-5331).
远程医疗可以改善慢性疾病的治疗，如癫痫。在2019冠状病毒病（COVID-19）大流行期间，远程医疗的普及率和使用率有所增加。然而，癫痫患者对远程医疗以及与健康相关的移动应用程序（应用）的熟悉程度和使用情况仍不清楚。我们在多中心Epi2020横断面研究中调查了远程医疗的使用、人口统计学和临床变量。在2020年10月至12月期间，成年癫痫患者完成了一份经过验证的问卷，包括关于应用和远程医疗的知识及使用情况的个人问题。在纳入的476名个体中（58.2%为女性；平均年龄40.2±15.4岁），41.6%的人报告使用过与健康相关的应用。健康应用（计步器32.1%，运动应用17.6%）的使用频率高于医疗应用（健康保险15.1%，月经应用12.2%）或专为癫痫设计的应用（用药提醒10.3%，癫痫发作日历4.6%）。很少有人使用癫痫发作探测器（即作为医疗设备的应用1.9%）或移动健康设备（健身手环11.3%）。大多数人（60.9%）听说过远程医疗这个词，其中78.6%的人持积极看法。然而，只有28.6%的人对远程医疗有具体概念，只有16.6%的人报告有过远程医疗的个人经历。大多数人（55%）愿意参加远程会诊随访，41.2%的人在医疗紧急情况下愿意。50.8%的人认为数据隐私和数据可用性同样重要，21.8%的人认为数据隐私更重要，20.2%的人认为数据可用性更重要。当前与健康相关的应用使用情况与年龄较小（=0.003）、高等教育程度（<0.001）以及与COVID-19相关的主观挑战（=0.002）独立相关。在多变量逻辑回归分析中，持续癫痫发作（与癫痫发作自由≥12个月相比）并不影响使用远程会诊的意愿。尽管对远程医疗看法积极，但德国很少有癫痫患者熟悉特定的应用或服务。社会经济因素对远程医疗使用的影响大于癫痫的基线特征。远程医疗教育和服务应针对社会经济弱势群体，以缩小数字医疗差距。德国临床试验注册中心（DRKS00022024；通用试验编号：U1111-1252-5331）。
