Principal Findings and Implications
PD, comorbidity, peritonitis
ANDERSEN, PERITONITIS
In this study, the rates of telehealth service use in patients undergoing CAPD for over 4 months after enrollment in the RCT study were examined. The results showed that the rates of telehealth service use declined significantly over time. This finding is consistent with those from previous studies on patients undergoing PD and having other chronic conditions [Regarding the factors influencing telehealth service use, predisposing characteristics (age and perceived usefulness), enabling resources (employment status), and need factors (perception of illness) significantly influenced its use. In this study, older age was a significant influencing factor of telehealth service use. This finding agrees with those from previous studies that older patients were more likely to adhere to the use of telehealth services than younger patients [This study confirmed that perceived usefulness was an explanatory factor that exerted the most significant effect on telehealth service use, which is consistent with the results reported in several previous studies [Employment status was another key influencing factor in telehealth service use. Unemployed participants, especially retired groups, tend to use the telehealth service more frequently than employed ones. Based on the theoretical framework [In this study, perception of illness was the least significant factor contributing to telehealth service use. Participants perceiving less severe illnesses were more likely to use the telehealth service. Certain findings from this study are comparable to those reported in previous studies, which showed that patients with poor health conditions, high levels of comorbidity, or low baseline health were less likely to adopt health-related technology, including telehealth [Furthermore, this study evaluated the relationships between the rates of telehealth service use and health outcomes, including quality of life and peritonitis, in this population. The results showed that higher rates of telehealth service use had a positive impact on quality of life. These findings are comparable to those from previous studies on patients undergoing PD [This study has important theoretical and practical implications. Theoretically, the factors influencing the use of telehealth services have been investigated using the Andersen behavioral model, which has contributed to expanding the theoretical scope of this model. Additionally, this study has provided valuable insights into the influential factors for patients undergoing CAPD, which are likely to be beneficial for increasing the use of telehealth services in this patient group. Unlike other studies related to telehealth service use, this study has paid attention to the actual and continued use of this service, which is important for the success of health care technologies, particularly in the context of a developing country. This research has further examined the consequences of using the telehealth service, in contrast to previous studies that were focused on identifying the determinants of use intention or actual use behavior.Regarding the practical implications, the findings of this study can be used by telehealth service developers, health care providers, and health-related institutions in Thailand and other countries, particularly low- and middle-income countries, to increase the use of telehealth services. More attention should be paid to the predisposing characteristics (age and perceived usefulness), enabling resources (employment status), and needs (perception of illness) of end users in the future to develop telehealth services for enhancing the use of this technology in patients with CAPD. Telehealth service should be easy to use to encourage and enhance its use in older patients with CAPD, thereby augmenting access to care. This study can also serve as a basis for developing an effective telehealth service and determining the optimal level of its use to promote better user outcomes. Health care policy makers should consider integrating this service with standard care as it can support home-based therapy and enhance health outcomes.