Image of Keren Ladin, Ph.D.; Image credit: Brigham and Women's Hospital
Keren Ladin, Ph.D.; Image credit: Brigham and Women’s Hospital

Older patients with chronic kidney disease (CKD), their care partners and their healthcare providers have mixed opinions on the value of telehealth care, with physicians least satisfied, a new study finds. The results highlight opportunities for improving telehealth care for older adults with complex chronic conditions, the researchers say.

Investigators conducted interviews with 30 CKD patients, 11 patient care partners and 19 physician specialists between August and December 2020. The interviews revealed four key themes that characterize the benefits and drawbacks of telehealth for these older, chronically ill adults: inconsistent quality of care, patient experience and engagement, loss of connection, and mistrust and disparities with accessing telehealth, Keren Ladin, Ph.D., of Tufts University, reported. 

“Clinicians were generally dissatisfied with telehealth, while most patients expressed more balanced perspectives, appreciating its convenience,” Ladin and colleagues wrote. Perceived benefits included convenience, perceived safety, care partner engagement and an enhanced ability of the clinician to understand the patient home environment. 

Among perceived drawbacks, both clinicians and patients emphasized loss of connection, an issue which contributed more to clinician dissatisfaction than it did to patients’. Telehealth also contributed to mistrust among some patients, mainly among patients of color, the researchers noted. These patients “emphasized their preference to see the clinician in person and watch their body language,” they said.

“Future studies should examine strategies to promote patient-centered telehealth, given that patients’ and clinicians’ perceptions of telehealth are critical to widespread telehealth adoption,” the researchers concluded.

The study was published in JAMA Network Open.