Remote consultations in primary care during the COVID-19 pandemic: student perspectives

Mulvihill, C; Cooper, Josephine; Pavey, Josh; Laake, Jean-Pierre

doi:10.1136/postgradmedj-2020-139149

Cited by 12 publications

(20 citation statements)

References 5 publications

(6 reference statements)

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“…As mentioned earlier, face-to-face appointments in English primary care decreased by over 50% between April and August 2020 compared to the same time period in 2019 [ 6 ]. Although the face-to-face consultations were largely replaced by remote consultations, patients with hearing loss, language barriers and those less able to use digital technology were disadvantaged in accessing primary care services [ 14 ]. Similarly, patients who are less verbally articulate were difficult to diagnose during a remote consultation, as a face-to-face consultation provides an opportunity for healthcare professionals to pick up on visual cues [ 14 ].…”

Section: Discussionmentioning

confidence: 99%

“…Although the face-to-face consultations were largely replaced by remote consultations, patients with hearing loss, language barriers and those less able to use digital technology were disadvantaged in accessing primary care services [ 14 ]. Similarly, patients who are less verbally articulate were difficult to diagnose during a remote consultation, as a face-to-face consultation provides an opportunity for healthcare professionals to pick up on visual cues [ 14 ]. This may have hindered the ability to diagnose acute infection and hence led to the reduction in prescribing of first-line antibiotics.…”

Section: Discussionmentioning

confidence: 99%

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Impact of the COVID-19 Pandemic on the Prescribing Patterns of First-Line Antibiotics in English Primary Care: A Longitudinal Analysis of National Prescribing Dataset

2021

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The COVID-19 pandemic has impacted on public access to health services. This study aimed to investigate the impact of COVID-19 pandemic on commonly prescribed first-line antibiotics in English primary care. A secondary analysis of publicly available government data pertaining to primary care prescribing was conducted. A list of twenty first-line antibiotics used to treat common infections was developed following the National Institute of Clinical Excellence (NICE) guidelines. All primary care prescription and cost data pertaining to commonly prescribed first-line antibiotics in England between March and September of 2018–2020 were extracted and adjusted for inflation. Analysis suggests prescribing of antibiotics significantly reduced by 15.99% (p = 0.018) and 13.5% (p = 0.002) between March and September 2020 compared with same time period for 2018 and 2019, respectively. The most noticeable decrease in 2020 was noticed for prescribing for meningitis (−62.3%; p = 0.002) followed by respiratory tract infections (−39.13%; p = 0.035), in terms of indications. These results are suggestive of reduced transmission of infections in the community due to national lockdowns, social distancing and hygiene practices. In addition, the impact of reduced face-to-face consultations in general practices needs to be investigated as a potential reason for reduced prescribing. The pandemic also offers an opportunity to rationalize antibiotics use in the community.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Impact of the COVID-19 Pandemic on the Prescribing Patterns of First-Line Antibiotics in English Primary Care: A Longitudinal Analysis of National Prescribing Dataset

2021

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“…During these reviews, the PA's clinical progression could also be explored; for example, would they be happier with more face-to-face appointments to increase their confidence in certain complaints, or would they prefer more autonomy to book their own face-to-face appointments. 12 Periodic pastoral care in PA supervision is likely to be of utmost importance during the pandemic to ensure the safety and continued progression of this workforce member. Such mentoring should also be malleable to match the growing confidence of the PA and decisions should be collaborative.…”

Section: Recommendations For Practicementioning

confidence: 99%

Remote consultations for physician associates in primary care: qualitative feedback from a regional cohort study

Hoskin¹,

Agarwal

2021

Future Healthcare Journal

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The advent of the COVID-19 pandemic necessitated a dramatic shift in the traditional general practice (GP) model of consultation. General practice was forced to deliver care remotely and this workforce included physician associates (PAs), who may not have been previously exposed to remote consultations prior to the pandemic. A qualitative online questionnaire explored how a cohort of primary care PAs in Sheffield adapted to the use of remote consultations, how clinically safe they felt in utilising this method, supervision arrangements in their practices and how they would manage three clinical scenarios. Recommendations are limited by the small sample size, but based upon this feedback we recommend inclusion of remote consultation as part of the student experience in higher educational institutions (HEIs) that do not currently utilise it; discussion of the PAs' previous experience of remote consultation at their induction in order to decide how to most effectively use their skillset while they transition into remote consultations, appreciating that they may have a lower threshold to invite patients in for a face-to-face appointment if newly qualified; on-demand supervision for remote consultations where possible; and reinforcement of clinical and pastoral review from the employer to manage the increasing scope of the PA.

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“…This is arguably even more important given the increased proportion of telephone consultations recently, which reduce the opportunity to identify visual cues suggestive of mental health problems. 23…”

Section: Accessing Psychological Therapiesmentioning

confidence: 99%

Realising the potential of Improving Access to Psychological Therapies for older adults

2020

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Remote consultations in primary care during the COVID-19 pandemic: student perspectives

Cited by 12 publications

References 5 publications

Impact of the COVID-19 Pandemic on the Prescribing Patterns of First-Line Antibiotics in English Primary Care: A Longitudinal Analysis of National Prescribing Dataset

Impact of the COVID-19 Pandemic on the Prescribing Patterns of First-Line Antibiotics in English Primary Care: A Longitudinal Analysis of National Prescribing Dataset

Remote consultations for physician associates in primary care: qualitative feedback from a regional cohort study

Realising the potential of Improving Access to Psychological Therapies for older adults

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