Skip to main content
Top
Published in: BMC Medical Informatics and Decision Making 1/2020

01-12-2020 | Hypertension | Research article

Assessment of willingness to Tele-monitoring interventions in patients with type 2 diabetes and/or hypertension in the public primary healthcare setting

Authors: David Yang Ern Sin, Xiaoxuan Guo, Dayna Wei Wei Yong, Tian Yu Qiu, Peter Kirm Seng Moey, Muller-Riemenschneider Falk, Ngiap Chuan Tan

Published in: BMC Medical Informatics and Decision Making | Issue 1/2020

Login to get access

Abstract

Background

Tele-monitoring (TM) is remote monitoring of individuals via info-communication technology, enabling them and their relatives or care-providers to recognize their health status conveniently. TM will be successful only if the individuals, often patients with medical conditions, are willing to accept and adopt it in their daily lives. This study aimed to determine the prevalence of willingness of patients with type 2 diabetes mellitus (T2DM) and/or hypertension towards the use of TM, and the factors influencing their uptake.

Methods

A cross-sectional survey was conducted at two public primary care clinics (polyclinics) in north-eastern Singapore, where TM had not been implemented. After the patients with T2DM and/or hypertension consented after fulfilling the eligibility criteria, they were first introduced to the concept of TM using pictogram and explanation by the investigators. Data on their demography, clinical parameters, technological literacy and acceptance of TM based on the Health Information Technology Acceptance Model (HITAM) were subsequently collected, computed, analyzed, followed by regression analyses to identify the factors associated with their willingness to use TM.

Results

Among 1125 eligible multi-ethnic Asian patients approached, 899 of them completed the assisted questionnaire survey, yielding a response rate of 79.9%. Their mean age was 58 ± 8 years, females 51.3% and Chinese 69.3%. Overall, 53.0% of the patients were willing to use TM. Personal beliefs on technology (OR = 3.54, 95%CI = 2.50–4.50, p < 0.001), prior technology utility (OR = 3.18, 95%CI = 1.57–6.42, p = 0.001), Patient’s requirements to be accompanied (OR = 1.48, 95% CI = 1.054–2.082, P = 0.03) Cost considerations (OR = 2.96, 95% CI = 2.257–3.388, P < 0.01) and technological literacy (OR = 2.77, 95%CI = 2.05–3.38, p < 0.001) were associated with willingness to use TM.

Conclusion

Slightly over half of the patients were willing to use TM. Factors such as age, ethnicity, technological literacy, beliefs and previous utility of technology of the patients have to be addressed before implementing TM in primary care.
Appendix
Available only for authorised users
Literature
1.
go back to reference Organisation, W.H. Telemedicine, opportunities and developments in Memeber states, Global Observatory for eHealth series; 2010. p. 2. Organisation, W.H. Telemedicine, opportunities and developments in Memeber states, Global Observatory for eHealth series; 2010. p. 2.
3.
go back to reference Losiouk E, et al. Parental evaluation of a telemonitoring service for children with type 1 diabetes. J Telemed Telecare. 2018;24(3):230–7.PubMedCrossRef Losiouk E, et al. Parental evaluation of a telemonitoring service for children with type 1 diabetes. J Telemed Telecare. 2018;24(3):230–7.PubMedCrossRef
4.
go back to reference Al-Ofi EA, et al. Management of postprandial hyperglycaemia and weight gain in women with gestational diabetes mellitus using a novel telemonitoring system. J Int Med Res. 2019;47(2):754–64.PubMedCrossRef Al-Ofi EA, et al. Management of postprandial hyperglycaemia and weight gain in women with gestational diabetes mellitus using a novel telemonitoring system. J Int Med Res. 2019;47(2):754–64.PubMedCrossRef
5.
go back to reference Margolis KL, et al. Long-term outcomes of the effects of home blood pressure Telemonitoring and pharmacist management on blood pressure among adults with uncontrolled hypertension: follow-up of a cluster randomized clinical trial. JAMA Netw Open. 2018;1(5):e181617.PubMedPubMedCentralCrossRef Margolis KL, et al. Long-term outcomes of the effects of home blood pressure Telemonitoring and pharmacist management on blood pressure among adults with uncontrolled hypertension: follow-up of a cluster randomized clinical trial. JAMA Netw Open. 2018;1(5):e181617.PubMedPubMedCentralCrossRef
6.
go back to reference Wild SH, et al. Supported Telemonitoring and glycemic control in people with type 2 diabetes: the Telescot diabetes pragmatic multicenter randomized controlled trial. PLoS Med. 2016;13(7):e1002098.PubMedPubMedCentralCrossRef Wild SH, et al. Supported Telemonitoring and glycemic control in people with type 2 diabetes: the Telescot diabetes pragmatic multicenter randomized controlled trial. PLoS Med. 2016;13(7):e1002098.PubMedPubMedCentralCrossRef
7.
go back to reference McKinstry B, et al. Telemonitoring based service redesign for the management of uncontrolled hypertension: multicentre randomised controlled trial. BMJ. 2013;346:f3030.PubMedPubMedCentralCrossRef McKinstry B, et al. Telemonitoring based service redesign for the management of uncontrolled hypertension: multicentre randomised controlled trial. BMJ. 2013;346:f3030.PubMedPubMedCentralCrossRef
8.
go back to reference Tucker KL, et al. Self-monitoring of blood pressure in hypertension: a systematic review and individual patient data meta-analysis. PLoS Med. 2017;14(9):e1002389.PubMedPubMedCentralCrossRef Tucker KL, et al. Self-monitoring of blood pressure in hypertension: a systematic review and individual patient data meta-analysis. PLoS Med. 2017;14(9):e1002389.PubMedPubMedCentralCrossRef
9.
go back to reference Organisation, W.H., Global status report on noncommunicable diseases 2014. 2014, World Health Organisation: WHO library cataloguing-in-publication data. Organisation, W.H., Global status report on noncommunicable diseases 2014. 2014, World Health Organisation: WHO library cataloguing-in-publication data.
10.
go back to reference Kim J, Park HA. Development of a health information technology acceptance model using consumers' health behavior intention. J Med Internet Res. 2012;14(5):e133.PubMedPubMedCentralCrossRef Kim J, Park HA. Development of a health information technology acceptance model using consumers' health behavior intention. J Med Internet Res. 2012;14(5):e133.PubMedPubMedCentralCrossRef
11.
go back to reference Gorst SL, et al. Home telehealth uptake and continued use among heart failure and chronic obstructive pulmonary disease patients: a systematic review. Ann Behav Med. 2014;48(3):323–36.PubMedCrossRef Gorst SL, et al. Home telehealth uptake and continued use among heart failure and chronic obstructive pulmonary disease patients: a systematic review. Ann Behav Med. 2014;48(3):323–36.PubMedCrossRef
12.
go back to reference Albert NM, et al. Factors associated with telemonitoring use among patients with chronic heart failure. J Telemed Telecare. 2017;23(2):283–91.PubMedCrossRef Albert NM, et al. Factors associated with telemonitoring use among patients with chronic heart failure. J Telemed Telecare. 2017;23(2):283–91.PubMedCrossRef
14.
go back to reference Asche SE, et al. Patient characteristics associated with greater blood pressure control in a randomized trial of home blood pressure telemonitoring and pharmacist management. J Am Soc Hypertens. 2016;10(11):873–80.PubMedPubMedCentralCrossRef Asche SE, et al. Patient characteristics associated with greater blood pressure control in a randomized trial of home blood pressure telemonitoring and pharmacist management. J Am Soc Hypertens. 2016;10(11):873–80.PubMedPubMedCentralCrossRef
15.
go back to reference Currell R, et al. Telemedicine versus face to face patient care: effects on professional practice and health care outcomes. Cochrane Database Syst Rev. 2000;2:CD002098. Currell R, et al. Telemedicine versus face to face patient care: effects on professional practice and health care outcomes. Cochrane Database Syst Rev. 2000;2:CD002098.
16.
go back to reference Heinzelmann PJ, Lugn NE, Kvedar JC. Telemedicine in the future. J Telemed Telecare. 2005;11(8):384–90.PubMedCrossRef Heinzelmann PJ, Lugn NE, Kvedar JC. Telemedicine in the future. J Telemed Telecare. 2005;11(8):384–90.PubMedCrossRef
17.
go back to reference Division, U.N.S., Percentage of individuals using the internet. 2014, United Nations Statistics Division: UNdata. Division, U.N.S., Percentage of individuals using the internet. 2014, United Nations Statistics Division: UNdata.
18.
go back to reference Fund, U.N.C.s., Internet Users. 2011, United Nations Statistics Division: UNdata. Fund, U.N.C.s., Internet Users. 2011, United Nations Statistics Division: UNdata.
19.
go back to reference Luo N, et al. Acceptance of information and communication technologies for healthcare delivery: a SingHealth polyclinics study. Ann Acad Med Singapore. 2009;38(6):529–8.PubMed Luo N, et al. Acceptance of information and communication technologies for healthcare delivery: a SingHealth polyclinics study. Ann Acad Med Singapore. 2009;38(6):529–8.PubMed
20.
go back to reference Phan TP, et al. Forecasting the burden of type 2 diabetes in Singapore using a demographic epidemiological model of Singapore. BMJ Open Diabetes Res Care. 2014;2(1):e000012.PubMedPubMedCentralCrossRef Phan TP, et al. Forecasting the burden of type 2 diabetes in Singapore using a demographic epidemiological model of Singapore. BMJ Open Diabetes Res Care. 2014;2(1):e000012.PubMedPubMedCentralCrossRef
22.
go back to reference Ministry of Health, S. National Health Survey 2010. Singapore: Ministry of Health: Ministry of Health; 2010. Ministry of Health, S. National Health Survey 2010. Singapore: Ministry of Health: Ministry of Health; 2010.
23.
go back to reference Bradford NK, Caffery LJ, Smith AC. Awareness, experiences and perceptions of telehealth in a rural Queensland community. BMC Health Serv Res. 2015;15:427.PubMedPubMedCentralCrossRef Bradford NK, Caffery LJ, Smith AC. Awareness, experiences and perceptions of telehealth in a rural Queensland community. BMC Health Serv Res. 2015;15:427.PubMedPubMedCentralCrossRef
24.
go back to reference Gwee KA, Setia S. Demographics and health care seeking behavior of Singaporean women with chronic constipation: implications for therapeutic management. Int J Gen Med. 2012;5:287–302.PubMedPubMedCentral Gwee KA, Setia S. Demographics and health care seeking behavior of Singaporean women with chronic constipation: implications for therapeutic management. Int J Gen Med. 2012;5:287–302.PubMedPubMedCentral
25.
go back to reference Singapore, G.o., General Household Survey 2015. 2016: Department of Singapore Statistics Website. Singapore, G.o., General Household Survey 2015. 2016: Department of Singapore Statistics Website.
26.
go back to reference Ayatollahi A, et al. Computer and internet use among undergraduate medical students in Iran. Pak J Med Sci. 2014;30(5):1054–8.PubMedPubMedCentral Ayatollahi A, et al. Computer and internet use among undergraduate medical students in Iran. Pak J Med Sci. 2014;30(5):1054–8.PubMedPubMedCentral
27.
go back to reference Forman LJ, Pomerantz SC. Computer-assisted instruction: a survey on the attitudes of osteopathic medical students. J Am Osteopath Assoc. 2006;106(9):571–8.PubMed Forman LJ, Pomerantz SC. Computer-assisted instruction: a survey on the attitudes of osteopathic medical students. J Am Osteopath Assoc. 2006;106(9):571–8.PubMed
28.
go back to reference Wiseman JT, et al. Conceptualizing smartphone use in outpatient wound assessment: patients' and caregivers' willingness to use technology. J Surg Res. 2015;198(1):245–51.PubMedPubMedCentralCrossRef Wiseman JT, et al. Conceptualizing smartphone use in outpatient wound assessment: patients' and caregivers' willingness to use technology. J Surg Res. 2015;198(1):245–51.PubMedPubMedCentralCrossRef
30.
go back to reference Ahmed SN, et al. Feasibility of epilepsy follow-up care through telemedicine: a pilot study on the patient's perspective. Epilepsia. 2008;49(4):573–85.PubMedCrossRef Ahmed SN, et al. Feasibility of epilepsy follow-up care through telemedicine: a pilot study on the patient's perspective. Epilepsia. 2008;49(4):573–85.PubMedCrossRef
31.
go back to reference Center, S.P.E.R. Sample Questionnaire Diabetes. 2007. Center, S.P.E.R. Sample Questionnaire Diabetes. 2007.
32.
go back to reference Nolte E, Knai C, Saltman RB. Assessing chronic disease management in European health systems, Concepts and approaches; 2014. Nolte E, Knai C, Saltman RB. Assessing chronic disease management in European health systems, Concepts and approaches; 2014.
33.
go back to reference Chow WL, et al. Factors that influence the choice of seeking treatment at polyclinics. Singapore Med J. 2012;53(2):109–15.PubMed Chow WL, et al. Factors that influence the choice of seeking treatment at polyclinics. Singapore Med J. 2012;53(2):109–15.PubMed
34.
go back to reference Singapore, D.o.S. Population trends 2017, D.o.S. Singapore, Editor: Department of Statistics Singapore website; 2017. Singapore, D.o.S. Population trends 2017, D.o.S. Singapore, Editor: Department of Statistics Singapore website; 2017.
35.
go back to reference Shaw RJ, et al. Organizational factors associated with readiness to implement and translate a primary care based telemedicine behavioral program to improve blood pressure control: the HTN-IMPROVE study. Implement Sci. 2013;8:106.PubMedPubMedCentralCrossRef Shaw RJ, et al. Organizational factors associated with readiness to implement and translate a primary care based telemedicine behavioral program to improve blood pressure control: the HTN-IMPROVE study. Implement Sci. 2013;8:106.PubMedPubMedCentralCrossRef
36.
go back to reference Watson AJ, et al. Reevaluating the digital divide: current lack of internet use is not a barrier to adoption of novel health information technology. Diabetes Care. 2008;31(3):433–5.PubMedCrossRef Watson AJ, et al. Reevaluating the digital divide: current lack of internet use is not a barrier to adoption of novel health information technology. Diabetes Care. 2008;31(3):433–5.PubMedCrossRef
37.
go back to reference Watson AJ, et al. Diabetes connected health: a pilot study of a patient- and provider-shared glucose monitoring web application. J Diabetes Sci Technol. 2009;3(2):345–52.PubMedPubMedCentralCrossRef Watson AJ, et al. Diabetes connected health: a pilot study of a patient- and provider-shared glucose monitoring web application. J Diabetes Sci Technol. 2009;3(2):345–52.PubMedPubMedCentralCrossRef
38.
go back to reference Office, P.M.s. About Smart Nation 2017 28 Feb 2017 [cited 2017 28 Feb]. Office, P.M.s. About Smart Nation 2017 28 Feb 2017 [cited 2017 28 Feb].
39.
go back to reference Cheng Wei A. Use SkillsFuture Credits for classes, seniors urged, in The Straits Times. Singapore: Press Holdings The Sunday Times; 2016. Cheng Wei A. Use SkillsFuture Credits for classes, seniors urged, in The Straits Times. Singapore: Press Holdings The Sunday Times; 2016.
41.
go back to reference Hall JL, McGraw D. For telehealth to succeed, privacy and security risks must be identified and addressed. Health Aff (Millwood). 2014;33(2):216–21.CrossRef Hall JL, McGraw D. For telehealth to succeed, privacy and security risks must be identified and addressed. Health Aff (Millwood). 2014;33(2):216–21.CrossRef
42.
go back to reference Maglogiannis I, et al. Enabling location privacy and medical data encryption in patient telemonitoring systems. IEEE Trans Inf Technol Biomed. 2009;13(6):946–54.PubMedCrossRef Maglogiannis I, et al. Enabling location privacy and medical data encryption in patient telemonitoring systems. IEEE Trans Inf Technol Biomed. 2009;13(6):946–54.PubMedCrossRef
Metadata
Title
Assessment of willingness to Tele-monitoring interventions in patients with type 2 diabetes and/or hypertension in the public primary healthcare setting
Authors
David Yang Ern Sin
Xiaoxuan Guo
Dayna Wei Wei Yong
Tian Yu Qiu
Peter Kirm Seng Moey
Muller-Riemenschneider Falk
Ngiap Chuan Tan
Publication date
01-12-2020
Publisher
BioMed Central
Published in
BMC Medical Informatics and Decision Making / Issue 1/2020
Electronic ISSN: 1472-6947
DOI
https://doi.org/10.1186/s12911-020-1024-4

Other articles of this Issue 1/2020

BMC Medical Informatics and Decision Making 1/2020 Go to the issue