Telemedicine and cystic fibrosis: Do we still need face-to-face clinics?

The Perceptions of Telehealth Physiotherapy for People with Bronchiectasis during a Global Pandemic—A Qualitative Study

“…The mixed views on future use of a telehealth physiotherapy model reflect reports in other populations, with some patients stating a preference for in-person consultations, while others anticipate use of telehealth beyond the pandemic [ 25 , 26 , 38 ]. It has been acknowledged that building rapport is facilitated when an existing real-life, in-person relationship is in place [ 35 ], a stance reflected by many participants in the current study. In addition, due to social distancing measures, patients have reported the need for inter-personal relationships and resuming human interaction with clinicians as part of their healthcare approach [ 25 ].…”

“…That it was considered to be a necessary adaption to ensure a continued service of delivery during the COVID-19 pandemic, when stay-at-home orders were stipulated, has been similarly reported in other populations [ 25 , 27 , 30 ]. The reduced burden of travel with telehealth services compared to in-person consultation has also been observed for those with chronic conditions [ 25 , 34 ], with lower reports of physical exhaustion in those with chronic respiratory conditions undertaking telehealth [ 30 , 35 , 36 ]. Reducing the risk of viral transmission during a pandemic [ 37 ] or the risk of infection linked to attending a healthcare facility [ 30 ], a particular concern for those with bronchiectasis, was also a perceived benefit of engaging with telehealth.…”

“…For some participants, views that the service provided was a replica of the in-person consultations has also been recently observed in studies of people with chronic conditions [ 26 , 38 ]. In those with cystic fibrosis, a telehealth physiotherapy model evaluated quality of life and physical activities levels and was considered a means to provide instruction and modification for airway clearance therapy with real-time feedback [ 35 ], with high levels of satisfaction with some services [ 25 ]. Greater focus and less socialization have been noted as benefits of virtual visits, which may enhance engagement for some participants [ 39 ].…”

“…As touch is considered one of the key distinguishing features which defines physiotherapy practice [ 43 ], a challenge of telehealth is the ability to create an alternative avenue for feedback and modification [ 44 ]. While medical personnel have reported minimal additional benefit related to auscultation for patients with respiratory disease [ 35 ], the absence of this tool during physiotherapy sessions was a concern for some participants in the current study. This, coupled with the elimination or substitution of assessment components which require physical examination, was a noted shortcoming, a perception previously observed in other populations [ 45 , 46 ].…”

The life rafts sailed; Now let's take stock and set the course ahead (Commentary)

“…Many centres were rapidly enabled with video-consultation software and some have provided families with weighing scales/ stadiometers, although funding for these has not been centralised. The period during which almost no children were seen in person was relatively short at our centre, which has moved to a hybrid model based on assessment of individual needs [4] , likely to continue to be embraced post-pandemic. A national assessment of future CF care will shortly be undertaken considering these widespread changes, the growing population of adults living with CF and the beneficial impacts of CFTR modulators realised over recent years.…”