Instrument for Assessing Patients' Desirability, Acceptability, and Adherence to Telemedicine in Diabetes: Development, Validity, and Reliability

Patient Prefer Adherence. 2021 Dec 4:15:2705-2713. doi: 10.2147/PPA.S343869. eCollection 2021.

Abstract

Purpose: To develop, test, and validate an instrument for assessing patients' desirability, acceptability, and adherence to telemedicine in diabetes.

Patients and methods: A group of six experts defined the components that needed to be assessed when developing telemedicine platforms aimed at improving the care of patients with diabetes. The resulting instrument was tested for reliability and construct validity of 114 patients with diabetes and re-tested for reproducibility and consistency on a sub-group of 34 patients. Based on the analysis, the questionnaire's syntax, phrasing, and flow were improved to obtain optimal assessment results.

Results: The resulting questionnaire has three major sections: one for the main evaluated component (acceptability, desirability, and adherence to telemedicine in diabetes), one for collecting socio-economic and demographical information, and one for diabetes history-related data, respectively. The corresponding data for these sections are collected using 29 questions. The developed instrument has a good reliability (Cronbach's alpha = 0.890), reproducibility (Total score 164 vs 166 points at re-test vs test; Mann-Whitney U p-value = 0.394) and external validity (Spearman's rho = -0.580; p < 0.001 for correlation with Patient's Health Questionnaire -9; and Spearman's rho = -0.516; p < 0.001 for correlation with Generalized Anxiety Disorder - 7).

Conclusion: The developed questionnaire is a valid and reliable instrument in assessing the patients' acceptability, desirability, and adherence to telemedicine use in diabetes care. In addition, the use of this instrument in the development of telemedicine platforms may improve and optimize their usage by providing valuable information regarding patients' preferences and specific needs.

Keywords: diabetes; eHealth; economics of care; health policies; self-care; telemedicine.