Access to mobile communication technology and willingness to participate in automated telemedicine calls among chronically ill patients in Honduras.
OBJECTIVE
patients in underdeveloped countries may be left behind by advances in telehealthcare. We surveyed chronically ill patients with low incomes in Honduras to measure their use of mobile technologies and willingness to participate in mobile disease management support.


METHODS
624 chronically ill primary care patients in Honduras were surveyed. We examined variation in telephone access across groups defined by patients' sociodemographic characteristics, diagnoses, and access to care. Logistic regression was used to identify independent correlates of patients' interest in automated telephonic support for disease management.


RESULTS
participants had limited education (mean 4.8 years), and 65% were unemployed. Eighty-four percent had telephone access, and 78% had cell phones. Most respondents had voicemail (61%) and text messaging (58%). Mobile technologies were particularly common among patients who had to forego clinic visits and medications due to cost concerns (each p < 0.05). Most patients (>80%) reported that they would be willing to receive automated calls focused on appointment reminders, medication adherence, health status monitoring, and self-care education. Patients were more likely to be willing to participate in automated telemedicine services if they had to cancel a clinic appointment due to transportation problems or forego medication due to cost pressures.


CONCLUSIONS
even in this poor region of Honduras, most chronically ill patients have access to mobile technology, and most are willing to participate in automated telephone disease management support. Given barriers to in-person care, new models of mobile healthcare should be developed for chronically ill patients in developing countries.
Ann Arbor VA Healthcare System, Ann Arbor, Michigan, USA. jpeitte@umich.edu
John D
JD
Piette
Milton O
MO
Mendoza-Avelares
Evan C
EC
Milton
Ilta
I
Lange
Roosevelt
R
Fajardo
D000368:Aged; D002908:Chronic Disease; D003625:Data Collection; D005260:Female; D006297:Health Services Accessibility; D006721:Honduras; D006801:Humans; D008297:Male; D008875:Middle Aged; D010361:Patients / Q000523:psychology*; D011203:Poverty; D012648:Self Care; D017216:Telemedicine / Q000706:statistics & numerical data*