{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,27]],"date-time":"2026-07-27T11:02:06Z","timestamp":1785150126879,"version":"3.55.0"},"reference-count":19,"publisher":"SAGE Publications","license":[{"start":{"date-parts":[[2026,1,1]],"date-time":"2026-01-01T00:00:00Z","timestamp":1767225600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"},{"start":{"date-parts":[[2026,1,1]],"date-time":"2026-01-01T00:00:00Z","timestamp":1767225600000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["Telemedicine Reports"],"published-print":{"date-parts":[[2026,1]]},"abstract":"<jats:sec>\n                    <jats:title>Background:<\/jats:title>\n                    <jats:p>Rural regions of Kazakhstan face persistent barriers to specialist access. Arterial hypertension (AH) remains highly prevalent, while limited digital literacy may restrict the uptake of telemedicine solutions.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Objective:<\/jats:title>\n                    <jats:p>To evaluate medical and digital literacy, patient satisfaction, and perceived barriers associated with cardiology teleconsultations for AH in rural Kazakhstan, and to explore changes in patient trust and demographic differences between survey phases.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods:<\/jats:title>\n                    <jats:p>\n                      A two-phase service evaluation was conducted. Phase 1 (offline, February 2023) surveyed rural adults with AH (\n                      <jats:italic toggle=\"yes\">n<\/jats:italic>\n                      = 134). Phase 2 implemented mobile-based cardiology teleconsultations (July 2023\u2013January 2024) and included a post-consultation online survey (\n                      <jats:italic toggle=\"yes\">n<\/jats:italic>\n                      = 51, September\u2013December 2024). Descriptive data were summarized as\n                      <jats:italic toggle=\"yes\">n<\/jats:italic>\n                      (%) or mean \u00b1 SD; inferential analyses included Welch\u2019s\n                      <jats:italic toggle=\"yes\">t<\/jats:italic>\n                      -test (age), the Wilcoxon signed-rank test (trust before\/after), Spearman correlation (digital literacy\u2014trust), the chi-square test (gender\u2014satisfaction), and Kruskal\u2013Wallis (age group\u2014satisfaction).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results:<\/jats:title>\n                    <jats:p>\n                      In Phase 1, awareness of hypertension and complications was high (96% and 76%), but knowledge of risk factors was lower (78%). Most participants owned a BP monitor (81%) and could measure blood pressure at home (78%); 40% did so daily. Digital engagement was limited\u201473% were unfamiliar with \u201cdigital medicine,\u201d and 75% did not use health apps. In Phase 2, 82% of patients found teleconsultations convenient, and 90% rated remote care as excellent or good; 73% rated physician performance as excellent. Reported barriers included poor internet connectivity (43%), and most consultations occurred via mobile phones (92%). The mean participant age declined from 59 \u00b1 11 years (offline) to 48 \u00b1 13 years (online) (Welch\u2019s t\n                      <jats:italic toggle=\"yes\">p<\/jats:italic>\n                      &lt; 0.0001). Trust in telemedicine significantly increased after the consultation (Wilcoxon\n                      <jats:italic toggle=\"yes\">p<\/jats:italic>\n                      &lt; 0.00001). Satisfaction did not differ by gender (\n                      <jats:italic toggle=\"yes\">p<\/jats:italic>\n                      = 0.79) or age group (\n                      <jats:italic toggle=\"yes\">p<\/jats:italic>\n                      = 0.349). A simplified cost analysis indicated \u223c66.7% lower per-visit cost compared with in-person consultations.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions:<\/jats:title>\n                    <jats:p>Mobile teleconsultations for hypertension management were feasible, well accepted, and associated with a significant improvement in patient trust among rural populations. Targeted efforts to improve digital literacy and connectivity could enhance equitable adoption. Early economic signals support integrating teleconsultations into routine rural health care services.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1177\/26924366251407895","type":"journal-article","created":{"date-parts":[[2026,2,4]],"date-time":"2026-02-04T11:14:00Z","timestamp":1770203640000},"update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":1,"title":["Teleconsultations for Hypertension Management in Rural Kazakhstan: A Two-Phase Service Evaluation of Patient Satisfaction, Trust, and Feasibility"],"prefix":"10.1177","volume":"7","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-8336-391X","authenticated-orcid":false,"given":"Ainur","family":"Bilmakhanbetova","sequence":"first","affiliation":[{"name":"Astana Medical University, Astana, Kazakhstan."},{"name":"National Research Oncology Center, Astana, Kazakhstan."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Gulnara","family":"Kulkayeva","sequence":"additional","affiliation":[{"name":"Salidat Kairbekova National Research Centre for Health, Astana, Kazakhstan."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Telman","family":"Seisembekov","sequence":"additional","affiliation":[{"name":"Astana Medical University, Astana, Kazakhstan."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Serik","family":"Ibraev","sequence":"additional","affiliation":[{"name":"Astana Medical University, Astana, Kazakhstan."}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"179","published-online":{"date-parts":[[2026,2,4]]},"reference":[{"key":"e_1_3_3_2_2","doi-asserted-by":"publisher","DOI":"10.1001\/jamanetworkopen.2023.56070"},{"issue":"1","key":"e_1_3_3_3_2","first-page":"51","article-title":"Cardiovascular disease risk factors among rural Kazakh population","volume":"74","author":"Kulkayeva G","year":"2012","unstructured":"Kulkayeva G, , Harun-Or-Rashid MD, , Yoshitoku Y, et al. 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