Abstract
BACKGROUND/OBJECTIVES: Despite supporting guidelines and evidence, teledermatology adoption in Germany is low, also possibly due to a lack of services that reflect patients' preferences. This study investigates these preferences in psoriasis care and the influence of sociodemographic, geographic and disease-related factors. METHODS: A discrete choice experiment was conducted. The attributes included the two teledermatology modes (live-interactive, store-and-forward), treating physician, possibility to ask questions and acknowledgment of concerns. The opportunity to prefer the standard of care was given. Participants were randomly assigned to two scenarios: consultation for acute flare-ups or follow-up. Conditional logit models were used for analysis. RESULTS: Among 221 patients with psoriasis (mean age: 58.9 years, 39.8% female), a general preference for the standard of care was observed (acute: β = -0.86, p = 0.001; follow-up: β = -1.24, p = 0.001). Factors that positively influenced preference for teledermatology were medical care provided by the known physician (acute: β = 0.49, p < 0.001; follow-up: β = 0.51, p < 0.001), the possibility to ask questions (acute: β = 0.35, p < 0.001; follow-up: β = 0.52, p < 0.001) and a very good acknowledgment of patients' concerns (acute: β = 0.48, p < 0.001; follow-up: β = 0.50, p < 0.001). Immediate feedback (<24 h) was crucial in acute consultations (β = 0.51, p < 0.001). No preference for a teledermatology mode was noted in either scenario. In both scenarios, lower privacy concerns and higher technology acceptance positively influenced teledermatology preference. In acute care, current long waiting times, whereas in follow-up care, current regular blood sampling positively influenced the preference for teledermatology. CONCLUSIONS: Patients with psoriasis generally preferred standard-of-care over teledermatology. However, certain attributes positively influenced their preference for teledermatology, including consultations with their known treating physician, acknowledgment of patient concerns and prompt consultation during acute flare-ups. Adapting services to these preferences could increase the use of teledermatology.