Disparities in Telehealth Care in Multiple Sclerosis
Ruth Ann Marrie, Leanne Kosowan, Gary Cutter, Robert J. Fox, Amber Salter
Abstract
Background and Objectives: The COVID-19 pandemic has dramatically increased telehealth use. We assessed access to and use of telehealth care, including videoconferencing and usability of videoconferencing, among persons with multiple sclerosis (MS). Methods: In Fall 2020, we surveyed participants in the North American Research Committee on Multiple Sclerosis Registry. Participants reported availability and receipt of MS care or education through telehealth. Participants who completed ≥1 live videoconferencing visit completed the Telehealth Usability Questionnaire (TUQ). We tested factors associated with access to and receipt of telehealth care using logistic regression. We tested factors associated with TUQ scores using quantile regression. Results: Of the 8,434 participants to whom the survey was distributed, 6,043 responded (71.6%); 5,403 were eligible for analysis. Of the respondents, 4,337 (80.6%) were women, and they had a mean (SD) age of 63.2 (10.0) years. Overall, 2,889 (53.5%) reported access to MS care via telehealth, and 2,110 (39.1%) reported receipt of MS care via telehealth including 1,523 (28%) via videoconference. Among participants who reported telehealth was available, older age was associated with decreased odds of having a telehealth video visit; higher income and being physically active were associated with increased odds. Older age and moderate to very severe visual symptoms were associated with lower perceived usability of telehealth. Discussion: Older age, lower socioeconomic status, and disease-related impairments are associated with less access to and use of telehealth services in people with MS. Barriers to telehealth should be addressed to avoid aggravating health care disparities when using digital medicine.