Will you go the distance? A satisfaction survey of telemedicine in sexual medicine

Abstract

Abstract Background The success of telemedicine depends on patient satisfaction with the care that they receive, which is impacted by the ease of use of the technology, quality of the connection, and perceived effectiveness of care. Aim The study sought to evaluate patient satisfaction with telemedicine services in a high-volume andrology clinic. Methods We included all patients who had a telemedicine appointment between January 1, 2020, and August 22, 2022. Demographic information was gathered, and a satisfaction survey was conducted using REDCap software. Data were grouped into 2 age categories, with ≥50 years as the cutoff (19-50 years; >50 years). The data were analyzed according to age, distance from the patient’s home to our center, and survey responses. Pearson’s chi-square test and ordinal logistic regression analyses were performed. Outcomes The main outcome is satisfaction with telemedicine in a men’s sexual health context. Results A total of 4071 patients were identified based on attending a telemedicine visit. Hypogonadism was the most common diagnosis. Other diagnoses included erectile dysfunction, varicocele, Peyronie’s disease, vasectomy, and infertility. In total, 613 patients completed the survey, with a mean age of 56.6 years. Older patients were less likely to prefer telemedicine (odds ratio [OR], 0.55; 95% confidence interval [CI], 0.36-0.80; P < .001), less likely to agree to a video visit because of privacy concerns (OR, 0.51; 95% CI, 0.35-0.75; P < .001), and less likely to recommend a telemedicine visit compared with their younger counterparts (OR, 0.37; 95% CI, 0.27-0.51; P < .001). The median distance was 22.4 (interquartile range, 7.5-57.5) miles. However, there was no significant association between distance and patients’ likelihood of preferring telehealth visits, including reviews of outside laboratories and imaging (OR, 1; 95% CI, 0.99-1; P = .35), belief in the quality of care provided via video visits (OR, 0.99, CI 0.99-1; P = .25), and overall preference for telehealth visits (OR, 0.99; 95% CI, 0.99-1; P = .35). Clinical Implications Healthcare providers should consider the age of patients when deciding to offer telemedicine while addressing privacy concerns to provide adequate reassurance to patients who may have concerns about the quality of care provided through telemedicine. Strengths and Limitations Our study achieved a substantial sample size that reached statistical significance. Conducted at a single academic center, our study was constrained, possibly introducing biases related to the institution’s advanced telemedicine system. Geographic and diagnostic limitations could lead to regional biases, affecting the generalizability of the findings. Conclusion Older patients exhibited a lower inclination toward preferring telemedicine, along with decreased odds of endorsing in-person visits.