Abstract
BackgroundThe impact of the COVID-19 pandemic on patients’ and clinicians’ perceptions of healthcare-seeking behaviour and delivery of care is unclear. The pandemic accelerated the use of remote care, and understanding its benefits and drawbacks may inform its implementation during current and future healthcare emergencies.AimTo explore patients’ and primary care professionals’ (PCPs) experiences of primary care delivery in the first wave of the pandemic.Design & settingQualitative study using semi-structured interviews in primary care in eight European countries (England, Ireland, Belgium, the Netherlands, Greece, Poland, Sweden, and Germany).MethodA total of 146 interviews were conducted with 80 PCPs and 66 patients consulting for respiratory tract infection (RTI) symptoms, in eight European countries. Data were collected between April and July 2020, and analysed using thematic analysis.ResultsIt was found that patients accepted telemedicine when PCPs spent time to understand and address their concerns, but a minority preferred in-person consultations. PCPs felt that remote consultations created emotional distance between themselves and patients, and they reported having to manage diverse COVID-19-related medical and social concerns.ConclusionRemote consultations for RTI symptoms may be acceptable long term if both groups are happy to use this format, but it is important that PCPs take time to address patients’ concerns and provide safety-netting advice.
Highlights
Primary care rapidly adjusted delivery of care at the onset of the COVID-19 pandemic
Studies conducted with clinicians during the COVID-19 pandemic found that they tried to provide patient-centred care during remote consultations by taking time to listen to patients’ concerns and providing relevant and appropriate reassurance.[14] with time, primary care professionals’ (PCPs) found them to be more time-consuming, clinically challenging, and less satisfying.[3]. This has been further magnified by the uncertainty in assessing respiratory and/or related COVID-19 symptoms remotely.[15,16] No studies explored patients’ and PCPs’ experiences of consulting and providing care for respiratory symptoms during the pandemic, illustrating a need to understand their experiences when dealing with symptoms that could be caused by COVID19
Key differences between primary care settings have been described elsewhere.[17]. To summarise, during the time of the data collection, in all countries, patients accessing primary care were triaged before they were able to come into the surgery.[17]. In most countries, triage was carried out over the telephone by either a PCP or a receptionist except in Greece and Sweden where triage took place by the practice door.[17]. The majority of patients with respiratory tract infection (RTI) symptoms had their consultations with a PCP over the telephone.[17]. Countries such as England, Belgium, Ireland, and the Netherlands later established COVID-hubs where patients with RTI symptoms could be seen by a PCP.[17]. Prior to the pandemic, telephone consultations were possible in all countries except in Belgium.[17]
Summary
Primary care rapidly adjusted delivery of care at the onset of the COVID-19 pandemic. Studies conducted with clinicians during the COVID-19 pandemic found that they tried to provide patient-centred care during remote consultations by taking time to listen to patients’ concerns and providing relevant and appropriate reassurance.[14] with time, PCPs found them to be more time-consuming, clinically challenging, and less satisfying.[3] This has been further magnified by the uncertainty in assessing respiratory and/or related COVID-19 symptoms remotely.[15,16] No studies explored patients’ and PCPs’ experiences of consulting and providing care for respiratory symptoms during the pandemic, illustrating a need to understand their experiences when dealing with symptoms that could be caused by COVID19. PCPs felt that remote consultations created emotional distance between themselves and patients, and they reported having to manage diverse COVID-19-related medical and social concerns
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