Background: It has been widely communicated that individuals with underlying health conditions are at higher risk of severe disease due to COVID-19 than healthy peers. As social distancing measures continue during the COVID-19 pandemic, experts encourage individuals with underlying conditions to engage in telehealth appointments to maintain continuity of care while minimizing risk exposure. To date, however, little information has been provided regarding telehealth uptake among this high-risk population. Objective: The aim of this study is to describe the telehealth use, resource needs, and information sources of individuals with chronic conditions during the COVID-19 pandemic. Secondary objectives include exploring differences in telehealth use by sociodemographic characteristics. Methods: Data for this study were collected through an electronic survey distributed between May 12-14, 2020, to members of 26 online health communities for individuals with chronic disease. Descriptive statistics were run to explore telehealth use, support needs, and information sources, and z tests were run to assess differences in sociodemographic factors and information and support needs among those who did and did not use telehealth services. Results: Among the 2210 respondents, 1073 (49%) reported engaging in telehealth in the past 4 months. Higher proportions of women engaged in telehealth than men (890/1781, 50% vs 181/424, 43%; P=.007), and a higher proportion of those earning household incomes of more than US $100,000 engaged in telehealth than those earning less than US $30,000 (195/370, 53% vs 241/530 45%; P=.003). Although 59% (133/244) of those younger than 40 years and 54% (263/486) of those aged 40-55 years used telehealth, aging populations were less likely to do so, with only 45% (677/1500) of individuals 56 years or older reporting telehealth use (P<.001 and P=.001, respectively). Patients with cystic fibrosis, lupus, and ankylosing spondylitis recorded the highest proportions of individuals using telehealth when compared to those with other diagnoses. Of the 2210 participants, 1333 (60%) participants either looked up information about the virus online or planned to in the future, and when asked what information or support would be most helpful right now, over half (1151/2210, 52%) responded “understanding how COVID-19 affects people with my health condition.” Conclusions: Nearly half of the study sample reported participating in telehealth in the past 4 months. Future efforts to engage individuals with underlying medical conditions in telehealth should focus on outreach to men, members of lower-income households, and aging populations. These results may help inform and refine future health communications to further engage this at-risk population in telehealth as the pandemic continues.

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中文翻译：

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COVID-19 期间慢性病患者的远程医疗使用和健康相关问题：对在线健康社区成员的调查

背景：人们广泛认为，有基础健康问题的个人比健康同龄人更容易因 COVID-19 而患上严重疾病。随着新冠肺炎 (COVID-19) 大流行期间社交距离措施的持续实施，专家鼓励有基础疾病的个人进行远程医疗预约，以保持护理的连续性，同时最大限度地减少风险暴露。然而，迄今为止，关于这一高危人群接受远程医疗的信息还很少。目的：本研究的目的是描述 COVID-19 大流行期间慢性病患者的远程医疗使用、资源需求和信息来源。次要目标包括探索社会人口特征在远程医疗使用方面的差异。方法：本研究的数据是通过 2020 年 5 月 12 日至 14 日期间向 26 个慢性病患者在线健康社区的成员分发的电子调查收集的。进行描述性统计来探索远程医疗的使用、支持需求和信息来源，并进行 z 检验来评估使用和不使用远程医疗服务的人在社会人口因素以及信息和支持需求方面的差异。结果：在 2210 名受访者中，1073 名 (49%) 表示在过去 4 个月内参与了远程医疗。从事远程医疗的女性比例高于男性（890/1781，50% vs 181/424，43%；P=0.007），家庭收入超过 100,000 美元的家庭从事远程医疗的比例也高于收入较高的家庭低于 30,000 美元（195/370, 53% vs 241/530 45%；P=.003）。尽管 40 岁以下人群中 59% (133/244) 和 40-55 岁人群中 54% (263/486) 使用远程医疗，但老龄化人群这样做的可能性较小，只有 45% (677/1500) 56 岁或以上的个人报告远程医疗使用情况（分别为 P<.001 和 P=.001）。与其他诊断的患者相比，患有囊性纤维化、狼疮和强直性脊柱炎的患者使用远程医疗的比例最高。在 2210 名参与者中，1333 名 (60%) 参与者要么在线查找有关病毒的信息，要么计划将来这样做，当被问及哪些信息或支持目前最有帮助时，超过一半的参与者 (1151/2210, 52%)回答“了解 COVID-19 如何影响与我有同样健康状况的人。” 结论：近一半的研究样本报告在过去 4 个月内参与了远程医疗。未来让患有基础疾病的个人参与远程医疗的努力应重点关注男性、低收入家庭成员和老龄化人口。这些结果可能有助于为未来的健康沟通提供信息和完善，以便随着大流行的持续，进一步让这些高危人群参与远程医疗。

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