The use of a multi-disciplinary geriatric telemedicine service (TELEG) and its acceptance at a tertiary care centre in Malaysia

BMC Geriatr. 2024 Feb 5;24(1):133. doi: 10.1186/s12877-024-04676-0.

Abstract

Background: The COVID-19 pandemic has fueled the widespread adoption of telemedicine in healthcare, particularly in Sarawak, Malaysia. This study investigates the use and acceptance of Sarawak's inaugural multidisciplinary geriatric telemedicine service, TELEG.

Methods: This cross-sectional study took place at the Sarawak Heart Centre's geriatric department from July 1, 2021, to April 30, 2022. Convenient sampling included all TELEG-enrolled patients during this period, to achieve minimum sample size of 148. TELEG's utilization was assessed in terms of medication therapy and treatment plan optimization, as well as enhanced healthcare accessibility. Participants' acceptance of TELEG was measured using the Service User Technology Acceptability Questionnaire (SUTAQ) administered through Google Forms. Descriptive statistics percentages illustrated the proportion of participants who found TELEG moderately to highly acceptable. Associations between baseline characteristics and overall acceptance were explored through bivariate analyses, including Pearson's correlation test, independent t-test, and ANOVA. The influence of six SUTAQ dimensions on overall acceptance, multivariable linear regression using enter method was employed. Statistical significance was determined by p-values less than 0.5.

Results: Among 180 geriatric patients enrolled in TELEG during the study period, 149 agreed to participate. TELEG led to medication therapy optimization for 88.6% of participants, primarily involving dose adjustment (44.7%), de-prescribing (31.8%), and prescribing (15.9%). Additionally, 53.8% received treatment plan optimization, predominantly in the form of self-care education (56.3%), referrals for further treatment (33.8%), additional laboratory investigations (29.6%), and increased monitoring (26.8%). Among those educated in self-care (n = 40), dietary intake (27.5%), lower limb exercise (25.0%), and COVID-19 vaccination (12.5%) were the most common topics. All participants expressed moderate to high acceptance of TELEG (mean = 4.9, SD = 0.65, on a scale of 1 to 6). Notably, care personnel concern (B = 0.256; p < 0.001) had the most significant impact on overall acceptance.

Conclusion: This pioneering study evaluates the utilization and user acceptance of a geriatric telemedicine service in the region, providing valuable insights to support its expansion. Follow-up surveys or interviews to gain insights into users' experiences are crucial to further enhance acceptance.

• This is the first paper that evaluate the use and acceptability of geriatric telemedicine in a developing country in the Southeast Asia region.

• TELEG is the leading multi-disciplinary geriatric telemedicine service implemented in Malaysia.

• The findings are important for policymakers in revising the existing legal and regulatory framework to govern the implementation and expansion of geriatric telemedicine in the region.

Keywords: Acceptance; Geriatric; Sustainability; Telemedicine; Use.

MeSH terms

  • Aged
  • COVID-19 Vaccines
  • Cross-Sectional Studies
  • Humans
  • Malaysia / epidemiology
  • Pandemics*
  • Telemedicine* / methods
  • Tertiary Care Centers

Substances

  • COVID-19 Vaccines