# Determinants of Patient Satisfaction in a Cardiac Telemedicine Clinic: A Cross-Sectional Study From Saudi Arabia

## TL;DR

This study from Saudi Arabia found that most patients were highly satisfied with a cardiac telemedicine clinic, with education level and fewer health conditions being key factors in satisfaction.

## Contribution

The study provides one of the first patient-centered evaluations of a cardiac telemedicine service in a non-urban Saudi region.

## Key findings

- 95.4% of patients rated their telemedicine experience as 'Good' or 'Excellent'.
- Higher education and fewer comorbidities were independently associated with higher satisfaction.
- Confidentiality and ease of use were the most highly rated aspects of the service.

## Abstract

Background

The rapid integration of telemedicine into cardiovascular care requires a comprehensive understanding of patient satisfaction to maintain service quality and equity. Although telemedicine adoption is increasing in Saudi Arabia, patient-centered evaluations, particularly for specialized services such as cardiology in non-urban regions, are lacking. This study assessed patient satisfaction and identified its key predictors within a cardiac telemedicine service in Najran, Saudi Arabia.

Patients and methods

A prospective cross-sectional study was conducted among 109 consecutive patients attending the Najran Cardiac Virtual Clinic between June and August 2024. Participants completed a validated electronic survey that collected sociodemographic data, clinical history, and satisfaction levels across 12 domains of telemedicine care, rated on a four-point Likert scale from Poor to Excellent. High overall satisfaction was defined as a composite score at or above the 75th percentile of the sample distribution. Predictors of satisfaction were identified using univariate and multivariable logistic regression models.

Results

The mean age of participants was 47.1±17.2 years, and 60 (55.0%) were female. Overall satisfaction was very high, with 104 patients (95.4%) rating their experience as "Good" or "Excellent." The highest-rated domains were confidentiality and privacy (104/109, 95.4% Good/Excellent) and ease of use (104/109, 95.4%). Multivariable analysis identified two independent predictors of high satisfaction: higher educational attainment (associated with 3.1 times higher odds of high satisfaction; adjusted odds ratio (aOR): 3.1, 95% CI: 1.2-8.0; p=0.019) and a lower count of comorbidities (fewer than three versus three or more comorbidities; aOR: 2.8, 95% CI: 1.1-7.3; p=0.034).

Conclusion

Cardiac telemedicine services in Najran achieved high patient satisfaction and demonstrated broad acceptability across age, gender, and residential settings. This study provides one of the first patient-centered evaluations of a dedicated cardiac telemedicine service in a non-urban region of Saudi Arabia. However, significantly lower satisfaction was reported by patients with lower educational attainment and those with multiple comorbidities. To ensure equitable delivery, these groups require prioritized interventions such as tailored digital literacy support, simplified interfaces, and integrated care pathways.