Telehepatology Use and Satisfaction Among Vulnerable Cirrhosis Patients Across Three Healthcare Systems in the Coronavirus Disease Pandemic Era
Background and Aims: Telehealth has emerged as an important mode of cirrhosis care delivery, but its use and satisfaction among vulnerable populations (eg, racial/ethnic minorities, socioeconomically disadvantaged, substance use disorders) are unknown. We evaluated digital capacity, telehealth use,...
| Main Authors: | , , , , , , , , , , , , , |
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| Format: | Article |
| Language: | English |
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Elsevier
2024-01-01
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| Series: | Gastro Hep Advances |
| Subjects: | |
| Online Access: | http://www.sciencedirect.com/science/article/pii/S2772572323001814 |
| _version_ | 1797295741823090688 |
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| author | Priyanka Athavale Robert J. Wong Derek D. Satre Alexander Monto Ramsey Cheung Jennifer Y. Chen Steven L. Batki Michael J. Ostacher Hannah R. Snyder Brigita D. Widiarto Seo Yoon Oh Meimei Liao Adele M.L. Viviani Mandana Khalili |
| author_facet | Priyanka Athavale Robert J. Wong Derek D. Satre Alexander Monto Ramsey Cheung Jennifer Y. Chen Steven L. Batki Michael J. Ostacher Hannah R. Snyder Brigita D. Widiarto Seo Yoon Oh Meimei Liao Adele M.L. Viviani Mandana Khalili |
| author_sort | Priyanka Athavale |
| collection | DOAJ |
| description | Background and Aims: Telehealth has emerged as an important mode of cirrhosis care delivery, but its use and satisfaction among vulnerable populations (eg, racial/ethnic minorities, socioeconomically disadvantaged, substance use disorders) are unknown. We evaluated digital capacity, telehealth use, satisfaction and associated factors among patients receiving hepatology care via telehealth (telehepatology) across 2 Veterans Affairs and 1 safety-net Healthcare systems. Methods: English- and Spanish-speaking adults with cirrhosis (N = 256) completed surveys on telehealth use and satisfaction, quality of life, pandemic stress, alcohol use and depression. Logistic regression analyses assessed telehealth use and general linear models evaluated telehealth satisfaction. Results: The mean age was 64.5 years, 80.9% were male and 35.9% Latino; 44.5% had alcohol-associated cirrhosis; 20.8% had decompensated cirrhosis; 100% had digital (phone/computer) capacity; and 75.0% used telehepatology in the prior 6 months. On multivariable analysis, participants with alcohol-associated (vs not) cirrhosis were less likely and those with greater pandemic stress were more likely to use telehepatology (odds ratio = 0.46 and 1.41, respectively; P < .05). Better quality of life was associated with higher telehepatology satisfaction and older age was associated with lower satisfaction (β = 0.01 and −0.01, respectively; P < .05). Latinos had higher satisfaction, but alcohol use disorder was associated with less satisfaction with telehepatology visits (β = 0.22 and −0.02, respectively; P < .05). Conclusion: Participants had high telehepatology capacity, yet demographics and alcohol-related problems influenced telehepatology use and satisfaction. Findings underscore the need for interventions to enhance patient experience with telehepatology for certain vulnerable groups including those with alcohol-associated cirrhosis in order to optimize care delivery. |
| first_indexed | 2024-03-07T21:52:22Z |
| format | Article |
| id | doaj.art-70d5541e08d04c0f8bdc8d12bfd6997b |
| institution | Directory Open Access Journal |
| issn | 2772-5723 |
| language | English |
| last_indexed | 2024-03-07T21:52:22Z |
| publishDate | 2024-01-01 |
| publisher | Elsevier |
| record_format | Article |
| series | Gastro Hep Advances |
| spelling | doaj.art-70d5541e08d04c0f8bdc8d12bfd6997b2024-02-25T04:36:43ZengElsevierGastro Hep Advances2772-57232024-01-0132201209Telehepatology Use and Satisfaction Among Vulnerable Cirrhosis Patients Across Three Healthcare Systems in the Coronavirus Disease Pandemic EraPriyanka Athavale0Robert J. Wong1Derek D. Satre2Alexander Monto3Ramsey Cheung4Jennifer Y. Chen5Steven L. Batki6Michael J. Ostacher7Hannah R. Snyder8Brigita D. Widiarto9Seo Yoon Oh10Meimei Liao11Adele M.L. Viviani12Mandana Khalili13Division of Internal Medicine, University of California, San Francisco, San Francisco, CaliforniaDivision of Gastroenterology and Hepatology, Stanford University School of Medicine, Stanford, California; Division of Gastroenterology and Hepatology, Veterans Affairs Palo Alto Health Care System, Palo Alto, CaliforniaDepartment of Psychiatry and Behavioral Sciences, Weill Institute for Neurosciences, University of California, San Francisco, California; Division of Research, Kaiser Permanente Northern California, Oakland, CaliforniaDivision of Gastroenterology and Hepatology, Veterans Affairs San Francisco Health Care System, San Francisco, California; Division of Gastroenterology and Hepatology, Department of Medicine, University of California, San Francisco, San Francisco, CaliforniaDivision of Gastroenterology and Hepatology, Stanford University School of Medicine, Stanford, California; Division of Gastroenterology and Hepatology, Veterans Affairs Palo Alto Health Care System, Palo Alto, CaliforniaDivision of Gastroenterology and Hepatology, Department of Medicine, University of California, San Francisco, San Francisco, California; Division of Gastroenterology and Hepatology, Zuckerberg San Francisco General, San Francisco, CaliforniaDepartment of Psychiatry and Behavioral Sciences, Weill Institute for Neurosciences, University of California, San Francisco, California; Mental Health Service, Veterans Affairs San Francisco Health Care System, San Francisco, CaliforniaDepartment of Psychiatry and Behavioral Sciences, Stanford University School of Medicine, Palo Alto, California; Department of Psychiatry, Veterans Affairs Palo Alto Health Care System, Palo Alto, CaliforniaDepartment of Family and Community Medicine, University of California, San Francisco, CaliforniaDivision of Gastroenterology and Hepatology, Zuckerberg San Francisco General, San Francisco, CaliforniaDivision of Gastroenterology and Hepatology, Veterans Affairs San Francisco Health Care System, San Francisco, California; Division of Gastroenterology and Hepatology, Zuckerberg San Francisco General, San Francisco, CaliforniaDivision of Gastroenterology and Hepatology, Veterans Affairs Palo Alto Health Care System, Palo Alto, CaliforniaDivision of Gastroenterology and Hepatology, Zuckerberg San Francisco General, San Francisco, CaliforniaDivision of Gastroenterology and Hepatology, Department of Medicine, University of California, San Francisco, San Francisco, California; Division of Gastroenterology and Hepatology, Zuckerberg San Francisco General, San Francisco, California; Correspondence: Address correspondence to: Mandana Khalili, MD, University of California San Francisco, San Francisco General Hospital, 1001 Potrero Avenue, Building 5, Suite 3D4, San Francisco, California 94110.Background and Aims: Telehealth has emerged as an important mode of cirrhosis care delivery, but its use and satisfaction among vulnerable populations (eg, racial/ethnic minorities, socioeconomically disadvantaged, substance use disorders) are unknown. We evaluated digital capacity, telehealth use, satisfaction and associated factors among patients receiving hepatology care via telehealth (telehepatology) across 2 Veterans Affairs and 1 safety-net Healthcare systems. Methods: English- and Spanish-speaking adults with cirrhosis (N = 256) completed surveys on telehealth use and satisfaction, quality of life, pandemic stress, alcohol use and depression. Logistic regression analyses assessed telehealth use and general linear models evaluated telehealth satisfaction. Results: The mean age was 64.5 years, 80.9% were male and 35.9% Latino; 44.5% had alcohol-associated cirrhosis; 20.8% had decompensated cirrhosis; 100% had digital (phone/computer) capacity; and 75.0% used telehepatology in the prior 6 months. On multivariable analysis, participants with alcohol-associated (vs not) cirrhosis were less likely and those with greater pandemic stress were more likely to use telehepatology (odds ratio = 0.46 and 1.41, respectively; P < .05). Better quality of life was associated with higher telehepatology satisfaction and older age was associated with lower satisfaction (β = 0.01 and −0.01, respectively; P < .05). Latinos had higher satisfaction, but alcohol use disorder was associated with less satisfaction with telehepatology visits (β = 0.22 and −0.02, respectively; P < .05). Conclusion: Participants had high telehepatology capacity, yet demographics and alcohol-related problems influenced telehepatology use and satisfaction. Findings underscore the need for interventions to enhance patient experience with telehepatology for certain vulnerable groups including those with alcohol-associated cirrhosis in order to optimize care delivery.http://www.sciencedirect.com/science/article/pii/S2772572323001814Alcohol-Associated Liver DiseaseTelemedicineUnderservedNonalcoholic Fatty Liver DiseaseMetabolic dysfunction-associated steatotic liver diseaseMetALD |
| spellingShingle | Priyanka Athavale Robert J. Wong Derek D. Satre Alexander Monto Ramsey Cheung Jennifer Y. Chen Steven L. Batki Michael J. Ostacher Hannah R. Snyder Brigita D. Widiarto Seo Yoon Oh Meimei Liao Adele M.L. Viviani Mandana Khalili Telehepatology Use and Satisfaction Among Vulnerable Cirrhosis Patients Across Three Healthcare Systems in the Coronavirus Disease Pandemic Era Gastro Hep Advances Alcohol-Associated Liver Disease Telemedicine Underserved Nonalcoholic Fatty Liver Disease Metabolic dysfunction-associated steatotic liver disease MetALD |
| title | Telehepatology Use and Satisfaction Among Vulnerable Cirrhosis Patients Across Three Healthcare Systems in the Coronavirus Disease Pandemic Era |
| title_full | Telehepatology Use and Satisfaction Among Vulnerable Cirrhosis Patients Across Three Healthcare Systems in the Coronavirus Disease Pandemic Era |
| title_fullStr | Telehepatology Use and Satisfaction Among Vulnerable Cirrhosis Patients Across Three Healthcare Systems in the Coronavirus Disease Pandemic Era |
| title_full_unstemmed | Telehepatology Use and Satisfaction Among Vulnerable Cirrhosis Patients Across Three Healthcare Systems in the Coronavirus Disease Pandemic Era |
| title_short | Telehepatology Use and Satisfaction Among Vulnerable Cirrhosis Patients Across Three Healthcare Systems in the Coronavirus Disease Pandemic Era |
| title_sort | telehepatology use and satisfaction among vulnerable cirrhosis patients across three healthcare systems in the coronavirus disease pandemic era |
| topic | Alcohol-Associated Liver Disease Telemedicine Underserved Nonalcoholic Fatty Liver Disease Metabolic dysfunction-associated steatotic liver disease MetALD |
| url | http://www.sciencedirect.com/science/article/pii/S2772572323001814 |
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