Do older patients feel able to cope with illness following telephone consultations? A multi-practice survey in the UK

Jiwa, Moyez; Freeman, Jenny; Coleman, Martyn; Joesbury, Helen

doi:10.1185/030079905x26225

Cited by 5 publications

(7 citation statements)

References 3 publications

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“…Among studies reporting positive outcomes on the general care experience ( n = 11) [ 19 , 20 , 22 , 24 , 25 , 27 , 29 – 31 , 37 , 38 ], ‘user habit or preferences’ was the most cited determinant, reported as a barrier by three studies [ 22 , 25 , 29 ], as a facilitator by one study [ 27 ] and as a more ambivalent factor by five studies ( Supplementary Table S 4 ) [ 19 , 24 , 30 , 31 , 37 ]. ‘User habits or preferences’ was also the most cited barrier.…”

Section: Resultsmentioning

confidence: 99%

“…Among the two different studies reporting on health-related and behavioural outcomes, one reported on the ability to cope with illness using a validated tool and one on general health status using a validated questionnaire [ 25 , 30 ].…”

Section: Resultsmentioning

confidence: 99%

“…Only one study reported a positive outcome in health-related and behavioural outcomes [ 25 ]. This study only cited the ‘user habit or preferences’ as a determinant, reported as a barrier (Supplementary Table S 4 ).…”

Section: Resultsmentioning

confidence: 99%

“…The quality of the included studies was overall very high (Table 3 ). Only six studies had one item or more with unknown risk of bias due to unavailable, insufficient or unclear information [ 19 , 21 , 22 , 25 , 28 , 32 ]. Two studies had two items or more with unknown risk of bias [ 28 , 32 ].…”

Section: Resultsmentioning

confidence: 99%

“… During the study period, is the intervention administered (or exposure occurred) as intended? Benaque (2020) [ 29 ] , Spain ✓ ✓ ✓ X ✓ Jiwa (2005) [ 25 ] , UK ✓ ✓ ✓ Can’t tell ✓ Khoong (2020) [ 24 ] , USA ✓ ✓ ✓ ✓ ✓ Lam (2020) [ 23 ] , 2020 ✓ ✓ ✓ ✓ ✓ Van Houwelingen (2015) [ 20 ] , Netherlands ✓ ✓ ✓ ✓ ✓ Quantitative Descriptive Studies Is the sampling strategy relevant to address the research question? Is the sample representative of the target population?…”

Section: Resultsmentioning

confidence: 99%

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Telemedicine in the primary care of older adults: a systematic mixed studies review

et al. 2023

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Background Family physicians had to deliver care remotely during the COVID-19 pandemic. Their efforts highlighted the importance of developing a primary care telemedicine (TM) model. TM has the potential to provide a high-quality option for primary care delivery. However, it poses unique challenges for older adults. Our aim was therefore to explore the effects of TM and the determinants of its use in primary care for older adults. Methods In this systematic mixed studies review, MEDLINE, PsycINFO, EMBASE, CINHAL, AgeLine, DARE, Cochrane Library, and clinical trials research registers were searched for articles in English, French or Russian. Two reviewers performed study selection, data extraction and assessment of study quality. TM’s effects were reported through the tabulation of key variables. TM use determinants were interpreted using thematic analysis based on Chang’s framework. All data were integrated using a joint display matrix. Results From 3,328 references identified, 20 studies were included. They used either phone (n = 8), videoconference (n = 9) or both (n = 3). Among studies reporting positive outcomes in TM experience, ‘user habit or preferences’ was the most cited barrier and ‘location and travel time’ was the most cited facilitator. Only one study reported negative outcomes in TM experience and reported ‘comfort with patient communication’ and ‘user interface, intended use or usability’ as barriers, and ‘technology skills and knowledge’ and ‘location and travel time’ as facilitators. Among studies reporting positive outcomes in service use and usability, no barrier or facilitator was cited more than once. Only one study reported a positive outcome in health-related and behavioural outcomes. Conclusions TM in older adults’ primary care generally led to positive experiences, high satisfaction and generated an interest towards alternative healthcare delivery model. Future research should explore its efficacy on clinical, health-related and healthcare services use.

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Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

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Telemedicine in the primary care of older adults: a systematic mixed studies review

et al. 2023

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Information needs and preferences of women as they proceed through radiotherapy for breast cancer

Halkett

Kristjanson

Lobb

et al. 2012

Patient Education and Counseling

116

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A ‘telephone first’ approach to demand management in English general practice: a multimethod evaluation

Newbould

Ball

Abel

et al. 2019

Health Serv Deliv Res

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Background The increasing difficulty experienced by general practices in meeting patient demand is leading to new approaches being tried, including greater use of telephone consulting. Objectives To evaluate a ‘telephone first’ approach, in which all patients requesting a general practitioner (GP) appointment are asked to speak to a GP on the telephone first. Methods The study used a controlled before-and-after (time-series) approach using national reference data sets; it also incorporated economic and qualitative elements. There was a comparison between 146 practices using the ‘telephone first’ approach and control practices in England with regard to GP Patient Survey scores and secondary care utilisation (Hospital Episode Statistics). A practice manager survey was used in the ‘telephone first’ practices. There was an analysis of practice data and the patient surveys conducted in 20 practices using the ‘telephone first’ approach. Interviews were conducted with 43 patients and 49 primary care staff. The study also included an analysis of costs. Results Following the introduction of the ‘telephone first’ approach, the average number of face-to-face consultations in practices decreased by 38% [95% confidence interval (CI) 29% to 45%; p < 0.0001], whereas there was a 12-fold increase in telephone consultations (95% CI 6.3-fold to 22.9-fold; p < 0.0001). The average durations of consultations decreased, which, when combined with the increased number of consultations, we estimate led to an overall increase of 8% in the mean time spent consulting by GPs, although there was a large amount of uncertainty (95% CI –1% to 17%; p = 0.0883). These average workload figures mask wide variation between practices, with some practices experiencing a substantial reduction in workload. Comparing ‘telephone first’ practices with control practices in England in terms of scores in the national GP Patient Survey, there was an improvement of 20 percentage points in responses to the survey question on length of time to get to see or speak to a doctor or nurse. Other responses were slightly negative. The introduction of the ‘telephone first’ approach was followed by a small (2%) increase in hospital admissions; there was no initial change in accident and emergency (A&E) department attendance, but there was a subsequent small (2%) decrease in the rate of increase in A&E attendances. We found no evidence that the ‘telephone first’ approach would produce net reductions in secondary care costs. Patients and staff expressed a wide range of both positive and negative views in interviews. Conclusions The ‘telephone first’ approach shows that many problems in general practice can be dealt with on the telephone. However, the approach does not suit all patients and is not a panacea for meeting demand for care, and it is unlikely to reduce secondary care costs. Future research could include identifying how telephone consulting best meets the needs of different patient groups and practices in varying circumstances and how resources can be tailored to predictable patterns of demand. Limitations We acknowledge a number of limitations to our approach. We did not conduct a systematic review of the literature, data collected from clinical administrative records were not originally designed for research purposes and for one element of the study we had no control data. In the economic analysis, we relied on practice managers’ perceptions of staff changes attributed to the ‘telephone first’ approach. In our qualitative work and patient survey, we have some evidence that the practices that participated in that element of the study had a more positive patient experience than those that did not. Funding The National Institute for Health Research Health Services and Delivery Research programme.

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Do older patients feel able to cope with illness following telephone consultations? A multi-practice survey in the UK

Abstract: These data support an inclusive policy in the provision of telephone access to health care professionals in primary care. We conclude that older patients are not disadvantaged by consulting a primary care professional by telephone.

Cited by 5 publications

References 3 publications

Telemedicine in the primary care of older adults: a systematic mixed studies review

Telemedicine in the primary care of older adults: a systematic mixed studies review

Information needs and preferences of women as they proceed through radiotherapy for breast cancer

A ‘telephone first’ approach to demand management in English general practice: a multimethod evaluation

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