Background/Purpose: Autoinflammatory diseases (AID) are severe potentially life-threatening conditions requiring personalized therapy and monitoring which only few expert centers can provide. Long travel distances impede health equity and optimal AID care, especially in emergencies. Individualized care models based on integrative telemedicine consultations (video-c) with AID experts for primary care providers and patients could optimize AID care “close to patients’ homes”. Data on the acceptance of such care models for AID are scarce. The aim of this study was to evaluate the acceptance and influencing factors of a telemedicine enriched AID care model (video-c).

Methods: This prospective study investigated the influence of usefulness and ease of use on attitude and intention to use video-c in “close to home” AID care. Primary care providers caring for AID patients with ≥1 AID-center visit since 01/2019 were included. Personal expertise, desire for support in AID care and acceptance of video-c were recorded. Acceptance was assessed based on the Technology Acceptance Model (TAM; 7-point Likert scale) with 1 meaning no agreement and 7 meaning strong agreement. Influencing factors were tested by structural equation modeling (SEM). Analysis was performed using IBM SPSS Statistics 26 and MPLUS 7.

Results: The response rate was 54% (62/115). 87% of participants were pediatricians, 10% family physicians, and 3% internal medicine physicians; 40% were female. In AID treatment, 27.4% felt (very) unexperienced, 27.4% (very) experienced; 45.2% neutral. More support from AID experts was desired by 71%. Technical equipment for video-c was available to 56% of primary care providers. 64% indicated a positive attitude (≥5/7 points) towards video-c for AID care “close to home”; 60% would use video-c in practice (≥5/7 points). SEM confirmed acceptable model fitting (WRMR=0.81, CFI/TLI=0.98/0.98). Ease of use showed a significant association with perceived usefulness (β=0.66, p< 0.001). Perceived usefulness was positively associated with attitude towards video-c (β=0.98, p< 0.001). Ease of use and usefulness explained 94% of the variance in attitude towards video-c (R2=0.94). Perceived usefulness combined with attitude explained 93% of the variance in intention to use a video-c (R2=0.93).

Conclusion: Three out of four primary care providers wished for more expert support in AID patient care “close to patients’ home”. Integrative telemedicine enriched care models (video-c) for primary care providers and patients with AID experts can optimize local AID care. Perceived usefulness and ease of use are significant influencing factors that should be considered when conceptualizing video-c and implementing such care models.

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ACR Meeting Abstracts - https://acrabstracts.org/abstract/telemedicine-enriched-care-model-to-optimize-care-for-patients-with-autoinflammatory-diseases/