Experiences of patients and health care professionals on the quality of telephone follow-up care during the COVID-19 pandemic: a large qualitative study in a multidisciplinary academic setting

Abstract

ObjectiveTo evaluate the perceived quality of follow-up telephone consultations (TCs) from the perspective of patients and healthcare professionals (HCPs) of multiple medical disciplines during the COVID-19 pandemic.DesignA qualitative study using semi-structured interviews and reflexive thematic analysis.SettingSeven medical disciplines (general dermatology, dermato-oncology, head and neck oncology, internal medicine, medical oncology, gynaecological oncology and surgical oncology) at a large university hospital in the Netherlands.ParticipantsPatients who received and HCPs who provided TCs as a substitute for outpatient follow-up appointments during the COVID-19 pandemic.ResultsEighty-two patients and 58 HCPs were interviewed. Predominantly, patients and HCPs were satisfied with the quality of care by TCs. They regarded TCs as efficient, accessible and of acceptable quality, provided there was an established patient-HCP relationship, medical complaints were absent and physical examination was not indicated. However, most patients were worried about the accuracy of their health assessment in the absence of physical examination and non-verbal communication. Both patients and HCPs wish to use TCs in the future alternatively with face-to-face consultations.ConclusionThis study concludes that TCs seem a valuable contribution to the context of follow-up care and could partially replace face-to-face consultations. TCs can be performed in stable, chronic patients with whom a doctor-patient relationship has already been established. Face-to-face consultations are considered more appropriate in the case of new patients, challenging or emotionally charged consultations and when clinically relevant physical examination is indicated. Due to the context-dependent nature of experiences of patients and HCPs, TCs should be used with an individually customised approach based on patient and disease specifics, in which shared decision-making plays an extensive role. Before major implementation is considered, sufficient data on the safety regarding missed diagnoses or cancer recurrences should be assembled first.

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Management of pain in cancer patients— Lessons from practices during the COVID-19: A qualitative study of cancer care providers’ perspectives

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Experiences of cancer care in COVID-19: A longitudinal qualitative study

“…Reduction in outpatient follow-up visits was the most prevalent treatment modification in the early phase of the pandemic ( Powis et al, 2021 ), accompanied by a rapid introduction of digital communication ( de Joode et al, 2020 ; Powis et al, 2021 ). The shift to digital communication has been heralded as a ‘silver lining’ for cancer care ( Lombe et al, 2021 ), and welcomed by some patients ( Hasson et al, 2021 ; van Erkel et al, 2022 ). However, this and other studies have demonstrated that some cancer patients are less satisfied with emotional support during telephone consultations ( Bultz and Watson, 2021 ; Gotlib Conn et al, 2021 ; Kilgour et al, 2021 ; Page et al, 2022 ), find it less personal ( Zomerdijk et al, 2021 ) and are more likely to forget to ask questions ( Gotlib Conn et al, 2021 ).…”