Effects of the pandemic on adolescent and caregiver attitudes towards telemedicine use.

Abstract

Telemedicine use increased during the COVID-19 pandemic. We compared both adolescent/caregiver attitudes towards telemedicine pre- and intra-pandemic. In a tertiary care setting with a large remote catchment area, we conducted qualitative analysis of structured interviews with dyads of 11to18-year-old patients and their caregivers using NVivo during the pandemic and compared the findings to our previous research [1]. We enrolled 14 dyads (35±27 in-person visits and 4±3 telemedicine visits per participant) and compared these with 11 dyads before the pandemic. Adolescents' mean age was 15.2±2.1 years (range 11.2-18.2). The median distance to our medical center was 184.8 km (range 3.9-1,214 km, 6 dyads >100 km). While the preferred ratio of telemedicine to in-person visits was 2:1 in caregivers (like pre-pandemic), many emphasized telemedicine as the safer option. Interestingly, adolescents preferred more in-person visits during the pandemic (1:1 ratio) compared to pre-pandemic (2:1 ratio). Qualitative analysis identified two main themes: consultation-specific factors and contextual factors. Consultation-specific factors were more valued during in-person visits, especially by adolescents. Consultation-specific factors remained the same pre- and post-pandemic, however, adolescents more often emphasized comfort, communication, and personal connection for in-person visits during the pandemic. Contextual factors were valued for telemedicine by adolescents and caregivers, and telemedicine was identified as the norm during the pandemic. Interestingly, the two main contextual themes pre-pandemic: frustration with technological aspects of telemedicine and adolescents not taking telemedicine seriously, disappeared during the pandemic. No disadvantages for telemedicine in the contextual factors were identified during the pandemic. The COVID-19 pandemic changed the user-expressed attitudes (especially among adolescents) on the transfer to telemedicine for chronic care.