Older adults satisfied with using telehealth for primary care, study finds

Most adults aged 65 years and older were satisfied with using telehealth for their primary care visits during the first 14 months of the COVID-19 pandemic, a recent study found.

Although most of those surveyed wanted telehealth to remain available, researchers said they still preferred in-person care.

Before the pandemic, Roma Bhatia, MD, MPH, an editorial fellow at The New England Journal of Medicine, and colleagues noted in the Journal of the American Geriatrics Society that older adults were the least likely to utilize telehealth due to several factors, such as lower digital literacy.

“Pre-pandemic, telemedicine was found to be effective for monitoring chronic conditions such as hypertension, but not a substitute for in-person care of older adults with complex health issues,” they wrote.

During the pandemic, CMS introduced flexibilities so that physicians could be reimbursed the same amount as in-person care when delivering care through telehealth. Policymakers are currently debating the future of telehealth in the United States. To help inform their decisions, Bhatia and colleagues conducted a cross-sectional study to better understand older adults’ experiences with telehealth.

Between April 2020 and June 2021, Bhatia and colleagues analyzed survey data from 208 participants (61% female; 91% white) who received in-person care within 12 months prior to March 2020 and had at least one telehealth visit since March 16, 2020.

The participants rated their experiences through a questionnaire that inquired about their overall satisfaction with telehealth (seven-point scale) and their confidence on using cell phones, landlines, tablets and computers for visits (point-point scale). The questionnaires also asked participants to compare telehealth visits with in-person visits.

The researchers found that most participants were satisfied with their visits, with a median score of six points (25th percentile = five points; 75th percentile = seven points), while showing confidence in using technology for telehealth, with a median score of five points for both phones and computers.

Compared with an in-person visit, however, only 4.9% of participants said telehealth was better. In contrast, 35.1% of participants rated both visits the same, while 39.5% said a virtual visit was worse than its counterpart.

“Many participants felt that in-person visits were higher quality than telemedicine visits because of the ability of the PCP to observe them, to identify problems patients were unaware of and to complete a physical examination,” the researchers reported.

Despite preferences, Bhatia and colleagues said that participants envisioned a hybrid system of in-person and telehealth care in the future, with many suggesting telehealth would be best used for follow-up appointments and more simple issues.

The researchers noted that future studies should examine the outcomes of telehealth visits, particularly among older adults with multimorbidity and those who do not speak English.

“Our findings suggest that coverage of both audio-only and video visits should continue for adults [aged 65 years and older] as we continue to learn best uses of this technology in this population,” they wrote.