CO₂ emissions, costs, and satisfaction in telemedicine versus face-to-face follow-up of pediatric celiac disease.

OBJECTIVES

Patient travel accounts for around 10% of healthcare-related greenhouse gas emissions. Telemedicine (TM) may contribute to reducing emissions. This study aimed to compare CO2 emissions, costs, and satisfaction associated with TM versus face-to-face (FTF) visits for follow-up of pediatric patients with celiac disease (CeD).

METHODS

CeD patients (2-16 years), attending follow-up visits, were invited to choose between FTF or TM visits via Google Meet. Data on carbon footprint, cost, usability, and satisfaction (telehealth usability questionnaire [TUQ]), and dietary adherence (celiac dietary adherence test [CDAT]) were collected using Google Forms.

RESULTS

Between March 2023 and November 2024, 300 patients were invited and 131 included (58 TM, 73 FTF). Baseline characteristics were similar (gender, age, and respondent). CDAT scores were comparable (p = 0.9). Compared to FTF, TM visits were shorter (30 vs. 75 min), with lower CO₂ emissions (0.08 vs. 24.00 kg), fewer lost workdays (18.9% vs. 81.1%), and reduced costs (€0.55 vs. €15.7; all p < 0.001); satisfaction was high except for "reliability" (median score: 16).

CONCLUSIONS

TM is a sustainable alternative for CeD follow-up, reducing CO₂ emissions, costs, and time. High satisfaction supports broader TM implementation in line with environmental goals.