Telemedicine uptake behaviors and predictors of its acceptance among community-dwelling older adults with chronic diseases

• The growing popularity of leveraging telemedicine to support chronic disease management reflects its major role and efficacy in enabling self-care among older adults with multi-morbidity • Older adults report moderate levels of acceptance and perception towards telemedicine use which are influenced by income and predicted by enhanced care, increased accessibility, performance expectancy and facilitating conditions • Creative ways involving policy change, protocol implementation, and digital training to promote the merits of telemedicine and eradicate specific barriers are required to facilitate telemedicine adoption among this population This study aimed to identify the determinants of telemedicine acceptance among older adults with chronic disease in the primary care setting, for the purpose of promoting their adoption of these remote care approaches in future unprecedented global health emergencies. A cross-sectional quantitative assessment of telemedicine acceptance and perception was conducted among 200 outpatients ≥ 65 years conveniently sampled from two primary care centres in Singapore. Multivariate linear regressions were used to identify significant predictors of intention-to-use behaviors. Moderate levels of acceptability and perception were observed and about half of them (49%) agreed to integrate telemedicine into existing care processes. Those with higher income ( p = 0.003) or were more convinced of its benefits, ease of use, validation, plus a facilitative environment and positive impression of technology were more likely to utilise telemedicine ( r = 0.19 to 0.84; all p < 0.05). Among these factors, the perceived ability of telemedicine to enhance care was the strongest determinant ( β = 0.39; p < 0.001). Findings show that continued efforts to demonstrate the impact of telemedicine in improving patient-reported outcomes are desperately needed alongside attempts to maximise its potential and eliminate barriers to its uptake. Telemedicine remains a promising care coordination modality for the older population provided it can function and perform up to the desired expectations and needs. Given deep concerns about how telemedicine might affect care involvement, quality and the status of their clinical conditions, greater efforts to propel this transition through various avenues such as offering telemedicine as a complementary service will be essential.