Who chooses telehealth? A cross-sectional cohort study of diabetic patients in outpatient clinic follow-up

Telehealth, the remote delivery of healthcare services via digital communication technologies, effectively manages diabetes, yet factors influencing its use—particularly in primary care—remain underexplored. This cross-sectional study investigates factors affecting participation and continuity of telehealth services among 1,094 diabetic patients in General Outpatient Clinics (GOPC). Two dependent variables—participation and continuity—were assessed at recruitment (T1) and post-program (T3). Socio-demographic, clinical, and eHealth-related characteristics served as independent variables. Descriptive statistics and binary logistic regression were utilized, including interaction terms for moderation effects. Key findings indicated that initial participation was significantly associated with eHealth literacy, health-related internet use, and mobile technology confidence. For continuity, significant predictors included age, care frequency, and income source, with care frequency’s positive effect diminishing as eHealth literacy increased. Overall, this study highlights the importance of digital capabilities and household support. Guided by the Unified Theory of Acceptance and Use of Technology 2 (UTAUT2), the results suggest that certain UTAUT2 constructs, such as effort expectancy and facilitating conditions, may be particularly relevant for understanding telehealth engagement in this context. Trials Registration The study was registered on ClinicalTrials.gov (Identifier: NCT05183685 ) on 10 Dec 2022.