Churruca Kate, Foo Darran, Turner Andrew, Crameri Emily, Saba Maree, Spanos Samantha, Vickers Matthew, Braithwaite Jeffrey, Ellis Louise A
Australian Institute of Health Innovation, Macquarie University, Macquarie Park, Australia.
Healthdirect Australia Limited, Sydney, Australia.
JMIR Form Res. 2025 Feb 3;9:e68619. doi: 10.2196/68619.
Commercially run direct-to-consumer (DTC) telemedicine services are on the rise in countries such as Australia and the United States. These include DTC services that are web-based, largely asynchronous, and offer targeted treatment pathways for specific health issues (eg, weight loss or sexual function). It has been argued that DTC telemedicine improves access to health care and promotes patient empowerment. Despite research examining quality and safety issues, little is known about users' reasons for accessing DTC telemedicine services or their perceptions of them.
In this study, we aimed to examine the perspectives of Australian users accessing DTC telemedicine services, including the reasons for use, perceived benefits, and concerns, in addition to their usage and interaction with traditional general practice services.
A web-based cross-sectional survey including questions on demographics, published and validated scales, and author-developed closed- and open-response questions was administered via REDCap in 2023 to Australian adults accessing DTC telemedicine services.
Among the 151 respondents, most (136/151, 90.1%) had seen a general practitioner (GP) in the previous 12 months and were somewhat or very satisfied (118/136, 86.8%) with the care, just over half found it easy to get an appointment with their GP (76/151, 50.3%), and a quarter found it difficult (38/151, 25.2%). Among the 136 respondents who had seen a GP, more than half either "never" (55/136, 40.4%) or "rarely" (23/136, 16.9%) discussed the information and treatment received from DTC telemedicine service with their GP. The majority of respondents were using a DTC telemedicine service offering prescription skin care (92/151, 60.9%), had received treatment in the previous 6 months (123/151, 81.5%), and had self-initiated care (128/151, 84.8%). The most frequently cited reasons for using DTC telemedicine were related to convenience (97/121, 80.2%) and flexibility (71/121, 58.7%), while approximately a third of the sample selected that it was difficult to see traditional health care provider in their preferred time frame (44/121, 36.4%) and that the use of DTC telemedicine allowed them to gain access to services otherwise unavailable through traditional health care (39/121, 32.2%). Most participants felt "more in control" (106/128, 82.9%) and "in charge" of their health concern (102/130, 78.5%) when using DTC telemedicine services, in addition to having "more correct knowledge" (92/128, 71.9%) and "feeling better informed as a patient" (94/131, 71.8%). "Costs of services" (40/115, 34.8%) and "privacy" (31/115, 27%) were the most frequently reported concerns with using digital health care technologies such as DTC telemedicine.
We report that most users perceive DTC telemedicine services as offering ease of access and convenience, and that their use contributes to a greater sense of empowerment over their health. Concerns were related to data privacy and the costs of utilizing the services. Responses suggest that DTC telemedicine may be tapping into a previously unmet need, rather than complementing traditional health care provided by a GP.
在澳大利亚和美国等国家，商业运营的直接面向消费者（DTC）的远程医疗服务正在兴起。这些服务包括基于网络的、基本为异步的DTC服务，并为特定健康问题（如减肥或性功能）提供有针对性的治疗途径。有人认为，DTC远程医疗改善了医疗服务的可及性，并增强了患者的自主权。尽管有研究探讨了质量和安全问题，但对于用户使用DTC远程医疗服务的原因或他们对这些服务的看法却知之甚少。
在本研究中，我们旨在调查使用DTC远程医疗服务的澳大利亚用户的观点，包括使用原因、感知到的益处和担忧，以及他们使用传统全科医疗服务的情况和互动。
2023年，通过REDCap对使用DTC远程医疗服务的澳大利亚成年人进行了一项基于网络的横断面调查，其中包括有关人口统计学、已发表并经验证的量表以及作者编写的封闭式和开放式问题。
在151名受访者中，大多数（136/1, 90.1%）在过去12个月内看过全科医生（GP）并且对护理感到有些或非常满意（118/136, 86.8%），略超过一半的人认为很容易预约到他们的全科医生（76/151, 50.3%），四分之一的人觉得很难（38/151, 25.2%）。在看过全科医生的136名受访者中，超过一半的人“从未”（55/136, 40.4%）或“很少”（23/136, 16.9%）与他们的全科医生讨论从DTC远程医疗服务获得的信息和治疗。大多数受访者使用的是提供处方皮肤护理的DTC远程医疗服务（92/151, 60.9%），在过去6个月内接受过治疗（123/151, 81.5%），并且是自行开始护理的（128/151, 84.8%）。使用DTC远程医疗最常提到的原因与便利性（97/121, 80.2%）和灵活性（71/121, 58.7%）有关，而大约三分之一的受访者选择是因为在他们喜欢的时间范围内很难见到传统医疗服务提供者（44/121, 36.4%），并且使用DTC远程医疗使他们能够获得通过传统医疗无法获得的服务（39/121, 32.2%）。大多数参与者在使用DTC远程医疗服务时感觉“更能掌控”（106/128, 82.9%）并且对自己的健康问题“更有掌控感”（102/130, 78.5%），此外还“有更多正确的知识”（92/128, 71.9%）并且“作为患者感觉了解得更多”（94/131, 71.8%）。“服务成本”（40/115, 34.8%）和“隐私”（31/115, 27%）是使用DTC远程医疗等数字医疗技术最常报告的担忧。
我们报告称，大多数用户认为DTC远程医疗服务易于获取且方便，并且其使用有助于增强对自身健康的掌控感。担忧与数据隐私和使用服务的成本有关。调查结果表明，DTC远程医疗可能满足了以前未得到满足的需求，而不是补充全科医生提供的传统医疗服务。
