title: Patient Attitudes Toward Telemedicine for Diabetic Retinopathy.
abstract: Diabetic retinopathy (DR) is the leading cause of new-onset blindness in adults. Telemedicine is a validated, cost-effective method to improve monitoring. However, little is known of patients' attitudes toward telemedicine for DR. Our study explores factors that influence patients' attitudes toward participating in telemedicine.
  
  
  
  Ninety seven participants in a university and the Veterans Administration setting completed a survey. Only people with diabetes mellitus (DM) were included. The main outcome was willingness to participate in telemedicine. The other outcomes were perceived convenience and impact on the patient-physician relationship. Participants reported demographic information, comorbidities, and access to healthcare. Analysis was performed with t-tests and multivariable logistic regression.
  
  
  
  Demographic factors were not associated with the outcomes (all p > 0.05). Patients had decreased odds of willingness if they valued the patient-physician relationship (adjusted odds ratio [OR] = 0.08, confidence interval [CI] = 0.02-0.35, p = 0.001) or had a longer duration of diabetes (adjusted OR = 0.93, CI = 0.88-0.99, p = 0.02). Patients had increased odds of willingness if they perceived increased convenience (adjusted OR = 8.10, CI = 1.77-36.97, p = 0.01) or had more systemic comorbidities (adjusted OR = 1.85, CI = 1.10-3.11, p = 0.02).
  
  
  
  It is critical to understand the attitudes of people with DM where telemedicine shows promise for disease management and end-organ damage prevention. Patients' attitudes are influenced by their health and perceptions, but not by their demographics. Receptive patients focus on convenience, whereas unreceptive patients strongly value their patient-physician relationships or have long-standing DM. Telemedicine monitoring should be designed for people who are in need and receptive to telemedicine.
authors.affiliation: 1 Department of Ophthalmology and Visual Sciences, University of Michigan Medical School , Ann Arbor, Michigan.
authors.forename: Nita G
authors.initials: NG
authors.lastname: Valikodath
authors.affiliation: 2 Department of Ophthalmology, University of Washington , Harborview Medical Center, Seattle, Washington.
authors.forename: Thellea K
authors.initials: TK
authors.lastname: Leveque
authors.affiliation: 1 Department of Ophthalmology and Visual Sciences, University of Michigan Medical School , Ann Arbor, Michigan.
authors.forename: Sophia Y
authors.initials: SY
authors.lastname: Wang
authors.affiliation: 1 Department of Ophthalmology and Visual Sciences, University of Michigan Medical School , Ann Arbor, Michigan.|3 Institute for Healthcare Policy & Innovation, University of Michigan , Ann Arbor, Michigan.
authors.forename: Paul P
authors.initials: PP
authors.lastname: Lee
authors.affiliation: 1 Department of Ophthalmology and Visual Sciences, University of Michigan Medical School , Ann Arbor, Michigan.|3 Institute for Healthcare Policy & Innovation, University of Michigan , Ann Arbor, Michigan.
authors.forename: Paula Anne
authors.initials: PA
authors.lastname: Newman-Casey
authors.affiliation: 1 Department of Ophthalmology and Visual Sciences, University of Michigan Medical School , Ann Arbor, Michigan.
authors.forename: Sean O
authors.initials: SO
authors.lastname: Hansen
authors.affiliation: 1 Department of Ophthalmology and Visual Sciences, University of Michigan Medical School , Ann Arbor, Michigan.|3 Institute for Healthcare Policy & Innovation, University of Michigan , Ann Arbor, Michigan.
authors.forename: Maria A
authors.initials: MA
authors.lastname: Woodward
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001292:Attitude to Computers; D003930:Diabetic Retinopathy / Q000175:diagnosis*; D003941:Diagnostic Techniques, Ophthalmological; D005260:Female; D006801:Humans; D008297:Male; D008403:Mass Screening / Q000523:psychology*; D008875:Middle Aged; D010342:Patient Acceptance of Health Care / Q000523:psychology*; D010361:Patients / Q000523:psychology*; D011795:Surveys and Questionnaires; D017216:Telemedicine / Q000706:statistics & numerical data*
keywords: e-health; ophthalmology; telehealth; telemedicine