Patients' and physicians' experiences with remote consultations in primary care during the COVID-19 pandemic: a multi-method rapid review of the literature.

Robert Kerrison,Pradipti Verma

doi:10.3399/bjgpo.2021.0192

Abstract

BackgroundDuring the COVID-19 pandemic, many countries implemented remote consultations in primary care to protect patients and staff from infection.AimThe aim of this review was to synthesise the literature exploring patients’ and physicians’ experiences with remote consultations in primary care during the pandemic, with the further aim of informing their future delivery.Design & settingRapid literature review.MethodPubMed and PsychInfo were searched for studies that explored patients’ and physicians’ experiences with remote consultations in primary care. To determine the eligibility of studies, their titles and abstracts were reviewed, before the full article. Qualitative and quantitative data were then extracted from those that were eligible, and the data synthesised using thematic and descriptive synthesis.ResultsA total of 24 studies were eligible for inclusion in the review. Most were performed in the US (n = 6, 25%) or Europe (n = 7, 29%). Patient and physician experiences were categorised into perceived ‘advantages’ and ‘issues’. Key advantages experienced by patients and physicians included ‘reduced risk of COVID-19’ and ‘increased convenience’, while key issues included ‘a lack of confidence in or access to required technology’ and a ‘loss of non-verbal communication’ which degraded clinical decision-making.ConclusionThis review identified a number of advantages and issues experienced by patients and physicians using remote consultations in primary care. The results suggest that, while remote consultations are more convenient and protect patients and staff against COVID-19, they result in the loss of valuable non-verbal communication, and are not accessible to all.

Highlights

COVID-19, referred to as ‘SARS-CoV-2’, or ‘Coronavirus’, is a novel respiratory virus with an estimated mortality rate of 0.01-0.1%.1 COVID-19 is not the first discovered Coronavirus;[2] COVID-19 is of contemporary relevance, due to its ability to spread and cause severe disease.[3]COVID-19 is transmitted through droplets, emitted when sneezing, coughing, or speaking, and can enter through the eyes, nose, or mouth.[4]
This has led to a radical change in the delivery of primary care, with visits increasingly being conducted via remote consultation.[6]
Similar patterns have been observed in the UK, where less than 50% of appointments were face-to-face in 2020,8 with the majority replaced by telehealth.[9,10]

Summary

Introduction

COVID-19, referred to as ‘SARS-CoV-2’, or ‘Coronavirus’, is a novel respiratory virus with an estimated mortality rate of 0.01-0.1%.1. COVID-19 is transmitted through droplets, emitted when sneezing, coughing, or speaking, and can enter through the eyes, nose, or mouth.[4] To protect individuals, and the health services that treat them, several social distancing and disease prevention measures have been implemented by governments the world over (with a view of abolishing these, once immunity through vaccination and improvements in treatment are developed).[5]. Similar patterns have been observed in the UK, where less than 50% of appointments were face-to-face in 2020 (it was over 80% in 2019),[8] with the majority replaced by telehealth ( providers are being encouraged to increase the number of video consultations they perform).[9,10]

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