Patient Perspective of Telehealth for Retinal Disease during the COVID-19 Pandemic

ABSTRACT

Purpose: Amidst the COVID-19 pandemic, telemedicine has emerged as a safe and cost-effective alternative to traditional, in-person ophthalmology clinic visits. To better understand the implications of this technology on the patient-physician relationship, this study assessed patient perspectives about telemedicine to identify areas for improvement. Methods: A cross-sectional survey was distributed to patients at University Retina during July 2021. Responses regarding telehealth's ability to ease anxiety of contracting COVID-19, efficiency, patient education, quality of examination, and convenience were collected on a 5-point Likert scale. A positive attitude was defined as ≥ 4 average Likert rating for all questions. Frequencies of positive attitudes were compared across demographic factors by the Pearson chi-square test. Multivariate analysis was used to evaluate factors influencing patient preference for telehealth over traditional visits. Results: Of 103 respondents, most were female (53.8%), aged 65-74 (34.6%), and high school educated (46.2%). 38% of patients did not know their diagnosis and 62.1% had no prior history of telehealth usage. Overall, patients had a neutral attitude towards telehealth (mean Likert rating (SD) = 3.11/5 ± 0.82). Nearly one-third (31%) preferred telehealth over face-to-face visits. Questions regarding “patient education” had the greatest proportion of positive attitude, whereas “efficiency” had a largely negative attitude (both 63.1%). “Convenience” of telehealth yielded the highest number of responses in strong agreement or disagreement (38.9%). Patients with no history of telehealth usage more frequently reported negative attitudes compared to those with prior experience (87.5% vs. 71.8%, p = 0.046). Patients tended to respond more positively as education level increased, but this trend was not statistically significant (p = 0.18). On multivariate analysis, patients younger than 75 were more likely to prefer telehealth over in-person visits compared to patients 75 or older (odds ratio [OR] = 2.25, p = .007). Patient gender, knowledge of diagnosis, and history of past telehealth usage did not predict preference for telemedicine. Conclusions: Patients responded with a net neutral outlook on telehealth, indicating room for improvement. Efforts should focus on addressing technological inefficiencies and age-related barriers to patient satisfaction.