Primary Care Physicians' Intentions to Use Telemedicine in Sweden – A Survey Before and After the COVID-19 Pandemic

Fredric Karlsson, Sofia Olofsson, Hans Thulesius, Veronica Milos Nymberg, Björn Ekman, Mattias Rööst, Anna Lindgren, Miriam Pikkemaat

Keywords: telemedicine, primary care physicians, intentions, self-reported use, COVID-19 pandemic, Theory of Planned Behaviour

Background:

The use of text- and video-based telemedicine tools for patient contacts and consultations increased worldwide during the COVID-19 pandemic.

In 2019 we studied primary care physicians’ intentions to use telemedicine through the questionnaire Physician Attitudes and Intentions to use Telemedicine (PAIT) in two regions in southern Sweden. PAIT is based on the Theory of Planned Behaviour that predicts intentions to use telemedicine by examining three predictors: Attitudes, Subjective Norms, and Perceived Behavioural Control. The 2019 survey indicated that physicians had high behavioural intentions but low self-reported use of telemedicine.

Research questions:

Were there any changes in primary care physicians' behavioural intentions and self-reported use of telemedicine before compared to after the COVID-19 pandemic?

Method:

The 2019 PAIT web survey was resent 2022 to primary care physicians in the same two regions.
We used parametric and non-parametric statistics, and linear regression analyses, to test for significant differences in predictors, behavioural intentions, and self-reported use of telemedicine.

Results:

There were no significant differences in primary care physicians' behavioural intentions to use telemedicine between 2019 and 2022. Similarly, there were no significant differences in the main predictors of behavioural intentions toward telemedicine usage.

Self-reported use of video consultations increased in 2022 compared to 2019 (scores on a 7-point scale increased from 1.3 (sd 0.7) to 1.5 (sd 0.8), p=0.03). All other self-reported use of telemedicine was unchanged.
Median age and years of experience were similar in both years (2019: n=198, 44 years, 10 years; 2022: n=93, 43 years, 9 years). There were more women respondents in 2022 than in 2019 (67% vs 53%, p=0.06).

Conclusions:

Primary care physicians' behavioural intentions to use telemedicine did not change, and their self-reported utilization revealed limited changes between the year before the COVID-19 pandemic and 2022 for the two studied regions in southern Sweden.

Points for discussion:

What factors influenced primary care physicians' intentions and utilization of telemedicine during the COVID-19 pandemic and beyond?

What are successful strategies to overcome barriers and enhance the adoption of telemedicine among primary care physicians?

We invite participants to consider translating and adapting this survey in their respective countries or jurisdictions. The survey has been translated and adapted to an English context.

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