Factors contributing to decisions for giving treatment and referrals to patients with cognitive complaints in chat-based telemedicine services in Indonesia

Introduction: Chat-based telemedicine has become a popular method for consulting cognitive complaints in Indonesia, especially during the COVID-19 pandemic. This study explores patient characteristics and their correlation with physicians’ decisions on treatment and referral. Methods: A retrospective cross-sectional study analyzed secondary data from patient chat databases on Indonesian telemedicine platforms between March 2020 and December 2021. Bivariate and multivariable analysis were conducted. Results: Out of 1,016 patients (0.4% of 2,199,527 users), most were females under 40. Clinicians were more likely to provide pharmacological treatment for patients aged ≥60, females, or those with forgetfulness complaints or a history of cognitive disorders ( p < 0.01). Referral likelihood increased when caregivers filed complaints or prior diagnoses existed ( p < 0.01). Discussion: Clinicians’ decisions in telemedicine were influenced by age, gender, complaint type, and caregiver involvement. Further research is needed to improve telemedicine for cognitive care.