Abstract

BackgroundIt has been widely communicated that individuals with underlying health conditions are at higher risk of severe disease due to COVID-19 than healthy peers. As social distancing measures continue during the COVID-19 pandemic, experts encourage individuals with underlying conditions to engage in telehealth appointments to maintain continuity of care while minimizing risk exposure. To date, however, little information has been provided regarding telehealth uptake among this high-risk population.ObjectiveThe aim of this study is to describe the telehealth use, resource needs, and information sources of individuals with chronic conditions during the COVID-19 pandemic. Secondary objectives include exploring differences in telehealth use by sociodemographic characteristics.MethodsData for this study were collected through an electronic survey distributed between May 12-14, 2020, to members of 26 online health communities for individuals with chronic disease. Descriptive statistics were run to explore telehealth use, support needs, and information sources, and z tests were run to assess differences in sociodemographic factors and information and support needs among those who did and did not use telehealth services.ResultsAmong the 2210 respondents, 1073 (49%) reported engaging in telehealth in the past 4 months. Higher proportions of women engaged in telehealth than men (890/1781, 50% vs 181/424, 43%; P=.007), and a higher proportion of those earning household incomes of more than US $100,000 engaged in telehealth than those earning less than US $30,000 (195/370, 53% vs 241/530 45%; P=.003). Although 59% (133/244) of those younger than 40 years and 54% (263/486) of those aged 40-55 years used telehealth, aging populations were less likely to do so, with only 45% (677/1500) of individuals 56 years or older reporting telehealth use (P<.001 and P=.001, respectively). Patients with cystic fibrosis, lupus, and ankylosing spondylitis recorded the highest proportions of individuals using telehealth when compared to those with other diagnoses. Of the 2210 participants, 1333 (60%) participants either looked up information about the virus online or planned to in the future, and when asked what information or support would be most helpful right now, over half (1151/2210, 52%) responded “understanding how COVID-19 affects people with my health condition.”ConclusionsNearly half of the study sample reported participating in telehealth in the past 4 months. Future efforts to engage individuals with underlying medical conditions in telehealth should focus on outreach to men, members of lower-income households, and aging populations. These results may help inform and refine future health communications to further engage this at-risk population in telehealth as the pandemic continues.

Highlights

  • IntroductionAccording to the Centers for Disease Control and Prevention (CDC), people with underlying medical conditions (eg, autoimmune disease, chronic respiratory disease, and cancer) are at greater risk of severe illness from COVID-19 than those without pre-existing conditions [1]

  • According to the Centers for Disease Control and Prevention (CDC), people with underlying medical conditions are at greater risk of severe illness from COVID-19 than those without pre-existing conditions [1]

  • Higher proportions of women engaged in telehealth than men (890/1781, 50% vs 181/424, 43%; P=.007), and a higher proportion of those earning household incomes of more than US $100,000 engaged in telehealth than those earning less than US $30,000 (195/370, 53% vs 241/530 45%; P=.003)

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Summary

Introduction

According to the Centers for Disease Control and Prevention (CDC), people with underlying medical conditions (eg, autoimmune disease, chronic respiratory disease, and cancer) are at greater risk of severe illness from COVID-19 than those without pre-existing conditions [1]. For communities who must continue health care appointments and treatment regimens during the pandemic, telehealth, or electronic communication and information technologies to support health care [4], has been recommended as a feasible intervention to maintain continuity of care while adhering to social distancing and stay-at-home mandates [1,5,6,7,8,9]. Telehealth use rapidly increased during the initial spread of COVID-19 [10,11], little information is available regarding telehealth uptake among high-risk populations with underlying medical conditions during this pandemic. As social distancing measures continue during the COVID-19 pandemic, experts encourage individuals with underlying conditions to engage in telehealth appointments to maintain continuity of care while minimizing risk exposure. Little information has been provided regarding telehealth uptake among this high-risk population

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