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与风湿和肌肉骨骼疾病患者使用远程医疗相关的因素:对德国全国性调查数据的二次分析。

Factors Associated With Telemedicine Use Among Patients With Rheumatic and Musculoskeletal Disease: Secondary Analysis of Data From a German Nationwide Survey.

机构信息

Center for Health Services Research, Faculty of Health Sciences, Brandenburg Medical School Theodor Fontane, Rüdersdorf bei Berlin, Germany.

AGEIS, Université Grenoble Alpes, Grenoble, France.

出版信息

J Med Internet Res. 2023 Jan 27;25:e40912. doi: 10.2196/40912.


DOI:10.2196/40912
PMID:36705950
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC9919449/
Abstract

BACKGROUND: Previous studies have demonstrated telemedicine (TM) to be an effective tool to complement rheumatology care and address workforce shortage. With the outbreak of the COVID-19 pandemic, TM experienced a massive upswing. A previous study revealed that physicians' willingness to use TM and actual use of TM are closely connected to their knowledge of TM. However, it remains unclear which factors are associated with patients' motivation to use TM. OBJECTIVE: This study aims to identify the factors that determine patients' willingness to try TM (TM try) and their wish that their rheumatologists offer TM services (TM wish). METHODS: We conducted a secondary analysis of data from a German nationwide cross-sectional survey among patients with rheumatic and musculoskeletal disease (RMD). Bayesian univariate and multivariate logistic regression analyses were applied to the data to determine which factors were associated with TM try and TM wish. The predictor variables (covariates) studied individually included sociodemographic factors (eg, age and sex) and health characteristics (eg, disease type and health status). All the variables positively or negatively associated with TM try or TM wish in the univariate analyses were then considered for the Bayesian model averaging analysis after a selection based on the variance inflation factor (≤2.5). All the analyses were stratified by sex. RESULTS: Of the total 102 variables, 59 (57.8%) and 45 (44.1%) variables were found to be positively or negatively associated (region of practical equivalence ≤5%) with TM try and TM wish, respectively. A total of 16 and 8 determinant factors were identified for TM try and TM wish, respectively. Wishing that TM services were offered by rheumatologists, having internet access at home, residing 5 to 10 km away from the general practitioner's office, owning an electronic device, and being aged 40 to 60 years were among the factors positively associated with TM try and TM wish. By contrast, not yet being diagnosed with an RMD, having no prior knowledge of TM, having a bad health status, living in a rural area, not documenting one's health status, not owning an electronic device, and being aged 60 to 80 years were negatively associated with TM try and TM wish. CONCLUSIONS: Our results suggest that health status, knowledge, age, and access to technical equipment and infrastructure influence the motivation of patients with RMD to use telehealth services. In particular, older patients with RMD living in rural areas, who could likely benefit from using TM, are currently not motivated to use TM and seem to need additional TM support.

摘要

背景:先前的研究表明,远程医疗(TM)是补充风湿病学护理和解决劳动力短缺的有效工具。随着 COVID-19 大流行的爆发,TM 经历了大规模的增长。先前的一项研究表明,医生使用 TM 的意愿和实际使用 TM 与他们对 TM 的了解密切相关。然而,目前尚不清楚哪些因素与患者使用 TM 的动机有关。

目的:本研究旨在确定决定患者尝试 TM(TM try)和希望风湿病医生提供 TM 服务(TM wish)的因素。

方法:我们对德国全国性横断面调查中患有风湿和肌肉骨骼疾病(RMD)的患者进行了二次数据分析。对数据进行了贝叶斯单变量和多变量逻辑回归分析,以确定哪些因素与 TM try 和 TM wish 相关。研究的预测变量(协变量)单独包括社会人口统计学因素(例如年龄和性别)和健康特征(例如疾病类型和健康状况)。在单变量分析中与 TM try 或 TM wish 呈正相关或负相关的所有变量,在基于方差膨胀因子(≤2.5)进行选择后,均被考虑用于贝叶斯模型平均分析。所有分析均按性别分层。

结果:在总共 102 个变量中,有 59 个(57.8%)和 45 个(44.1%)变量与 TM try 和 TM wish 呈正相关或负相关(实用等价区域≤5%)。分别确定了 16 个和 8 个决定因素与 TM try 和 TM wish 相关。希望风湿病医生提供 TM 服务、在家中可以上网、距离全科医生办公室 5 至 10 公里、拥有电子设备以及年龄在 40 至 60 岁之间是与 TM try 和 TM wish 呈正相关的因素。相比之下,尚未被诊断出患有 RMD、对 TM 一无所知、健康状况不佳、居住在农村地区、不记录自己的健康状况、没有电子设备以及年龄在 60 至 80 岁之间与 TM try 和 TM wish 呈负相关。

结论:我们的结果表明,健康状况、知识、年龄以及获得技术设备和基础设施的机会会影响 RMD 患者使用远程医疗服务的动机。特别是,居住在农村地区、可能受益于 TM 的年龄较大的 RMD 患者目前没有动力使用 TM,似乎需要额外的 TM 支持。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/627d/9919449/f43322e00d3b/jmir_v25i1e40912_fig4.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/627d/9919449/a5428991c2ed/jmir_v25i1e40912_fig1.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/627d/9919449/6a9cb4099f42/jmir_v25i1e40912_fig2.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/627d/9919449/3680163cb7d4/jmir_v25i1e40912_fig3.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/627d/9919449/f43322e00d3b/jmir_v25i1e40912_fig4.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/627d/9919449/a5428991c2ed/jmir_v25i1e40912_fig1.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/627d/9919449/6a9cb4099f42/jmir_v25i1e40912_fig2.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/627d/9919449/3680163cb7d4/jmir_v25i1e40912_fig3.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/627d/9919449/f43322e00d3b/jmir_v25i1e40912_fig4.jpg

相似文献

[1]
Factors Associated With Telemedicine Use Among Patients With Rheumatic and Musculoskeletal Disease: Secondary Analysis of Data From a German Nationwide Survey.

J Med Internet Res. 2023-1-27

[2]
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[3]
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[4]
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引用本文的文献

[1]
Determinants of Having Online Health Consultations During the COVID-19 Pandemic Among Middle-Aged and Older Adults in Germany: Representative Longitudinal Survey Study.

JMIR Aging. 2025-5-26

[2]
Digital Transformation of Rheumatology Care in Germany: Cross-Sectional National Survey.

J Med Internet Res. 2025-1-6

[3]
Identification of Motivational Determinants for Telemedicine Use Among Patients With Rheumatoid Arthritis in Germany: Secondary Analysis of Data From a Nationwide Cross-Sectional Survey Study.

J Med Internet Res. 2024-8-19

[4]
Ortho-digital dynamics: Exploration of advancing digital health technologies in musculoskeletal disease management.

Digit Health. 2024-8-14

[5]
"The Simpler, the Better." A Qualitative Study on Digital Health Transformation in Early Adopter Rheumatology Outpatient Clinics.

Inquiry. 2024

[6]
Prediction of the acceptance of telemedicine among rheumatic patients: a machine learning-powered secondary analysis of German survey data.

Rheumatol Int. 2024-3

[7]
Factors Influencing the Behavioral Intentions and Use Behaviors of Telemedicine in Patients With Diabetes: Web-Based Survey Study.

JMIR Hum Factors. 2023-12-28

[8]
Digital Approaches for Myositis.

Curr Rheumatol Rep. 2023-12

本文引用的文献

[1]
Evaluation of the use of video consultation in German rheumatology care before and during the COVID-19 pandemic.

Front Med (Lausanne). 2022-11-25

[2]
Factors Associated With Telemedicine Use Among German General Practitioners and Rheumatologists: Secondary Analysis of Data From a Nationwide Survey.

J Med Internet Res. 2022-11-30

[3]
There's an app for that, but nobody's using it: Insights on improving patient access and adherence to digital therapeutics in Germany.

Digit Health. 2022-7-3

[4]
Patient's Perception of Digital Symptom Assessment Technologies in Rheumatology: Results From a Multicentre Study.

Front Public Health. 2022

[5]
The worldwide impact of telemedicine during COVID-19: current evidence and recommendations for the future.

Connect Health. 2022-1-4

[6]
Opportunities and Barriers of Telemedicine in Rheumatology: A Participatory, Mixed-Methods Study.

Int J Environ Res Public Health. 2021-12-13

[7]
Effectiveness of Telehealth in Rural and Remote Emergency Departments: Systematic Review.

J Med Internet Res. 2021-11-26

[8]
The positive side of the coin: Sars-Cov-2 pandemic has taught us how much Telemedicine is useful as standard of care procedure in real life.

Clin Rheumatol. 2022-2

[9]
The impact of the COVID-19 pandemic on professional practice and patient volume in medical practices: A survey among German physicians and psychotherapists.

Z Evid Fortbild Qual Gesundhwes. 2021-11

[10]
[Acceptance of video consultation among patients with inflammatory rheumatic diseases depends on gender and location-Results of an online survey among patients and physicians].

Z Rheumatol. 2023-3

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