Green epileptology: Acceptance of telemedical follow-up under climate protection aspects.

objectiveExpanding telemedicine services could reduce healthcare's environmental impact. This study aimed to assess the factors influencing the acceptance of telemedical follow-up in epilepsy care, with a particular focus on transportation methods, digital literacy, and environmental awareness.

methodsThe study surveyed adult patients treated at the Department of Epileptology, University Hospital Bonn, by using a 28-item questionnaire which assessed demographics, epilepsy characteristics, transportation, appointment preferences (including telemedicine), computer proficiency, online behavior, and environmental awareness.

resultsA total of 357 participants (54.6% female, 42% seizure-free, 83.8% on ASM) participated in the survey. Most (69.8%) preferred only in-person visits, 26.1% favored a hybrid model, and 4.1% preferred telemedicine exclusively. Digital literacy was high, with two-thirds reporting moderate to high proficiency in online skills, and three-quarters showed concern for environmental issues. Despite this, in-person visits remained the preferred option. Key disadvantages of telemedicine included lack of personal interaction (54.1%) and no blood tests (51.5%), whereas benefits included time savings (42.6%) and avoiding travel (52.7%). Concerns about missing in-person interaction were linked to lower telemedicine acceptance. In contrast, reduced infection risk, workplace absence, and travel avoidance, and environmental benefits were associated with a preference for a hybrid model. SIGNIFICANCE: Although participants expressed environmental awareness, their preference for in-person care highlights the gap between environmental attitudes and behaviors. A hybrid care model, combining telemedicine and in-person visits, appears to be the most viable solution, balancing patient needs with environmental sustainability. This study supports integrating telemedicine into routine practice as a way to reduce the carbon footprint of healthcare and enhance accessibility. PLAIN LANGUAGE SUMMARY: This study explored whether telemedicine can reduce healthcare's environmental impact by looking at epilepsy follow-up care. A survey of 357 patients found that most preferred in-person visits (70%), while 26% favored a hybrid mix, and only 4% wanted telemedicine alone. Although digital literacy was generally high, and many cared about the environment, face-to-face care remained the preferred option. Patients valued saving travel time and avoiding infection risk with telemedicine but missed personal interaction and blood tests. The findings suggest a hybrid approach is best, offering flexibility, reducing travel emissions, and supporting sustainability while meeting patients' clinical and social needs.