Use and preferences regarding internet-based health care delivery in patients with chronic kidney disease

Abstract

Background and objectives Internet-based technologies play an increasingly important role in the management and outcome of patients with chronic kidney disease (CKD). The healthcare system is currently flooded with digital innovations and internet-based technologies as a consequence of the coronavirus disease 2019 (COVID-19) pandemic. However, information about the attitude of German CKD-patients with access to online tools towards the use of remote, internet-based interactions such as video conferencing, email, electronic medical records and apps in general and for health issues in particular, are missing. Design, setting, participants, and measurements To address the use, habits and willingness of CKD patients in handling internet-based technologies we conducted a nationwide cross-sectional questionnaire survey in adults with CKD. Results We used 380 questionnaires from adult CKD patients (47.6% on dialysis, 43.7% transplanted and 8.7% CKD before renal replacement therapy) for analysis. Of these 18.9% denied using the internet at all (nonusers). Nonusers were significantly older (74.4 years, SD 11.4) than users (54.5 years, SD 14.5, p < 0.001), had a lower educational level than users (≥ 12 years: 6.9% versus 47.1%, p < 0.001) and were more often on dialysis. Within the group of internet users only a minority (2.6%) was using video conferencing with their physician, only 11.7% stated that they were using email to report symptoms and 26.6% were using the internet to schedule appointments. Slightly more than one-third of internet users (35.1%) are concerned that their personal medical data are not safe when submitted via the internet. Conclusions Within our group of German CKD-patients we found that almost one out of five patients, especially older patients and patients with a lower educational level, did not use the internet at all. The majority of internet users reported in our survey that they have not used internet-based technologies within a medical context so far, but are willing to consider it. Therefore, it seems to be important to introduce and teach motivated CKD-patients the use and benefits of simple and safe internet-based health care technologies.

Perceptions of Telehealth vs In-Person Visits Among Older Adults With Advanced Kidney Disease, Care Partners, and Clinicians

“…Sixteen clinicians (84%) were nephrologists (Table 1). The mean (SD) interview time was 30 (11) minutes.…”

“…Telehealth may improve access to patient-centered care, particularly for populations facing challenges with transportation or caregiving, and those seeking to distance during the pandemic. 8 , 9 , 10 Some patients with CKD appear willing to use telehealth, 11 , 12 and outcomes appear similar between those receiving telehealth vs in-person care in small, observational reports. 13 , 14 Surveys suggest that many patients with chronic conditions are satisfied with telehealth care, 14 , 15 , 16 and telehealth has been successfully used for CKD disease management.…”

“…Most studies involving patients have relied on surveys or claims data, which, although instructive, are insufficient for understanding telehealth experiences of older persons with chronic conditions. 11 , 19 , 23 , 24 , 25 This qualitative study conducted at 4 sites uniquely addresses these gaps by identifying factors affecting telehealth experiences of older adults with CKD, their care partners, and kidney clinicians to improve patient-centered telehealth.…”

Reorganização do serviço ambulatorial de referência para condições crônicas durante a pandemia da COVID-19

“…Pessoas com mais idade e com nível educacional mais baixo apresentavam dificuldades em utilizar outras ferramentas para atendimento remoto. 13 Os atendimentos, mesmo que na modalidade remota, foram meios de motivar a adesão à terapia medicamentosa e a mudanças de comportamento, necessárias para tratar o quadro crônico. 5 Além da assistência, o serviço manteve as atividades de apoio matricial para orientação dos casos que permaneceram sob monitoramento da APS.…”

Langfristige körperliche und psychische Folgen chronischer Nierenerkrankungen

“…Familiäre Beziehungen können gefährdet sein [ 19 , 20 , 32 – 39 ]. Die medizinpsychologischen Folgen sind altersspezifisch und müssen im Rahmen der Transition von der Kinder- in die Erwachsenennephrologie und bei der Behandlung älterer Patient:innen Berücksichtigung finden [ 40 – 42 ].…”