Objective To analyse general practitioner–patient consultations about type 2 diabetes mellitus or cardiovascular diseases and describe (i) the nature of self-management discussions; (ii) actions required from patients during and after consultation regarding self-management; and (iii) implications for digital health to support patients during (and after) consultation. Method This study screened 281 general practitioner consultations conducted in 2017 within the UK general practice setting from an existing dataset containing videos and transcripts of consultations between GPs and patients. Secondary analysis was conducted using a multi-method approach, including descriptive, content, and visualisation analysis, to inform the nature of self-management discussions, what actions are required from patients, and whether digital technology was mentioned during the consultation to support self-management. Results Analysis of eligible 19 consultations revealed a discord between what self-management actions are required of patients during and after consultations. Lifestyle discussions are often discussed in depth, but these discussions rely heavily on subjective inquiry and recall. Some patients in these cohorts are overwhelmed by self-management, to the detriment of their personal health. Digital support for self-management was not a major topic of discussion, however, we identified a number of emergent gaps where digital technology can support self-management concerns. Conclusion There is potential for digital technology to reconcile what actions are required of patients during and after consultations. Furthermore, a number of emergent themes around self-management have implications for digitalisation.
BackgroundThe COVID-19 pandemic significantly impacted primary care, resulting in rapid uptake of telehealth. Patients with chronic conditions like Type-2 Diabetes Mellitus (T2DM) and cardiovascular disease (CVD) relied heavily on telehealth consultations during this period. It is important to assess whether tasks observed during T2DM or CVD in-person consultations are translatable to telehealth.AimTo explore the extent to which in-person GP consultations are translatable to telehealth for patients with T2DM or CVD.Design & settingThis study screened 281 GP consultations conducted in 2017 within the UK general practice setting for consultations pertaining to T2DM or CVD. Seventeen in-person consultations (in de-identified video and transcript) were selected for further analysis.MethodDetailed reporting of tasks, physical artefacts, and physical examinations observed during in-person GP consultations. A new scoring method applying two key metrics, supporting definitions and examples was designed to assess translatability of clinical tasks, to telehealth.ResultsAcross 17 T2DM or CVD in-person consultations analysed, 23 clinical tasks, 21 physical artefacts, and nine physical examinations were observed. 60% of tasks analysed were deemed easily translatable to telehealth. 26% of tasks were rated as ‘translatable to telehealth’ but may require a patient obtaining their own equipment. 13% of tasks were rated as ‘potentially translatable to telehealth’. No clinical tasks for these cohorts were rated as untranslatable to telehealth.ConclusionMajority of tasks observed during T2DM or CVD in-person GP consultations are translatable to telehealth. Further research is warranted to investigate emergent safety concerns from increased uptake of telehealth.
BackgroundThe COVID-19 pandemic saw multiple general-practitioners (GPs) adopt telehealth as a consultation modality to minimise disease transmission. Patients presenting with respiratory ailments were particularly affected by this transition, given the overlap of general respiratory symptoms with those of COVID-19. It is unclear if the rapid transition to telehealth has compromised the ability to conduct certain tasks that were possible during in-person consultations.AimTo investigate the extent to which tasks observed during in-person GP consultations are replicable to telehealth, focusing on patients with respiratory concerns.Design & setting26 respiratory consultations were extracted from a database of 281 consultations collated from various general practices in the UK.MethodInteractions between GPs and respiratory patients were assessed through in-depth transcript review and de-identified video analysis. Then, tasks performed and physical artefacts utilised during the consultations were identified and ranked in terms of their translatability to telehealth using a newly developed scoring system.ResultsOverall, the translatability to telehealth score for these respiratory consultations was 6.7/10, suggesting that many tasks can be replicated over telehealth, but may require additional physical artefacts to support this. However, some tasks are not currently amenable to telehealth (eg, auscultation).ConclusionWhilst many aspects of respiratory consultations are replicable over telehealth, some tasks are unable to be replicated at this stage.
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