Consideration of Decisions for Giving Pharmacological Management and Referrals to Patients with Neuropathy Complaints in Application-Based Telemedicine Services in Indonesia

Introduction: Since the COVID-19 pandemic, application-based telemedicine services have begun to be used for patients with neuropathy complaints. This study describes the characteristics of patients with complaints of neuropathy in application-based telemedicine services in Indonesia and their influence on treatment decisions and referrals.Methods: This study is a retrospective cross-sectional study (March 2020-December 2021) using secondary data derived from patient chat databases on application-based telemedicine services in Indonesia. The analysis was then performed bivariate and multivariate.Results: Obtained 1051 patients with neuropathy complaints (0.0004%). Most of them are 40-64 years old women. The most comorbid experienced by the patient was diabetes mellitus (90,7%). Multivariate analysis of treatment decisions showed response to complaints (p<0.001), time of chronic vs. acute complaints (p = 0.005), and history of laboratory or other supporting test (p = 0.006) as significant factors in multivariate model. Multivariate analysis of referral decisions showed age 65 years vs under 40 years (p = 0.037), gender (p = 0.035), neurological responder vs. general practitioner (p<0.001), other specialist vs. general practitioner responder (p = 0.029) time of chronic vs. acute complaints (p = 0.017), history of hypertension (p<0.001), history of laboratory or other supporting test (p = 0.016) were significant factors in multivariate model.Conclusion: In the application-based telemedicine setting, several factors influence the decision to give pharmacological treatment and the decision to refer a doctor. Application-based telemedicine services can still be developed in the future to be better.