A Sino-Australian Study of Technology Access, Age and Attitudes toward Digital Communication: Implications for Telehealth — ASN Events
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A Sino-Australian Study of Technology Access, Age and Attitudes toward Digital Communication: Implications for Telehealth (#354)

Timothy Middleton 1 2 , Maria Constantino 1 2 , Lynda Molyneaux 2 , Margaret McGill 2 , Xia Zhang 3 , Zhangrong Xu 4 , Lei Zou 5 , Junping Zhu 5 , Jencia Wong 1 2 , Dennis Yue 1 2 , Ted Wu 2
  1. Discipline of Medicine, The University of Sydney, Sydney
  2. Diabetes Centre, Royal Prince Alfred Hospital, Sydney
  3. Department of Endocrinology and Metabolism, The Second Hospital of Dalian Medical University, Dalian, China
  4. The 306th Hospital, Beijing, China
  5. The Journal of Tang Niao Bing Zhi You, China

In the Western Pacific Region, China shares with Australia similarities of a large land mass and a large projected increase in diabetes prevalence1. Thus, in both countries there is substantial interest in developing telecommunication technology-based systems (telehealth) as a means of delivering cost-effective care2.  Uptake of telehealth is limited by patient access to and understanding of information technology.  We developed a survey tool to examine these issues in patients with diabetes which was administered to 518 Australian subjects from metropolitan and regional NSW and 535 Chinese subjects from mainland China who were subscribers to The Journal of Friends of Diabetes of China.  54% of respondents were male and 79% identified as having type 2 diabetes.  15% were <40 years, 31% were 40-60 years and 54% were >60 years.

 

In both Australia and China a minority of patients (<10%) did not have access to any form of information technology at home.  Technology access (including computer, printer, webcam, tablet and mobile phone) was generally greater in the <40 year age group (Table 1).  The most commonly accessed form of technology was the mobile phone and there was a similar level of access in both Australia (83%) and China (79%).  All forms of technology were accessed more commonly in Australia, in contrast to China where the usage of fixed computers and associated peripherals was far less prevalent.  On the question of comfort with technology, 26% of Australian and 27% of Chinese respondents expressed some level of discomfort.  Notably, there was a distinct age-related trend with young respondents expressing less discomfort with technology than their older counterparts (Table 2).

 

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Widespread access to mobile phones presents an opportunity to develop a mobile health (mHealth) platform to facilitate patient-clinician communication and enhance care of diabetes patients.  Given the highly favourable attitudes expressed by younger patients, a mHealth intervention targeted to those aged <40 years would appear to offer the greatest prospect for success.

  1. Guariguata, L; Whiting, DR & Hambleton, I et al. Global estimates of diabetes prevalence for 2013 and projections for 2035. Diabetes Research and Clinical Practice 2014; 103: 137-149
  2. Zhai YK et al. Clinical- and cost-effectiveness of telemedicine in type 2 diabetes mellitus: a systematic review and meta-analysis. Medicine (Baltimore) 2014; 93(28): e312