The Effective Management of Idiopathic Intracranial Hypertension Delivered by In-person and Virtual Group Consultations: Results and Reflections from a Phase One Service Delivery

Wong, Sui; Barrow, Nadia; Hall, Kylie; Gandesha, P; Manson, Alison

doi:10.1080/01658107.2021.1887287

Cited by 7 publications

(4 citation statements)

References 11 publications

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“…To the authors’ knowledge, only two small-scale pilot studies have been published on VGCs so far (in secondary care in the UK and in a community-based outpatient diabetes clinic in rural Guam), reporting improvement in some patient and service outcomes. 30 , 31 A larger body of work on face-to-face group consultations corroborates improvements in biomedical outcomes and patient satisfaction for those participating in groups across a range of conditions and settings. 15 , 32 – 34 The patient interviewees in the present study had largely positive experiences, but a few challenged the value of remote group-based care, owing to concerns about digital inclusion and distraction from the clinician–patient relationship.…”

Section: Discussionmentioning

confidence: 86%

Implementing video group consultations in general practice during COVID-19: a qualitative study

2022

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Background: Group consultations have been gaining ground as a novel approach to service delivery. When in-person care was restricted due to Covid-19, general practice staff started delivering group consultations remotely over video. Aim: To examine how multiple interacting influences underpinned implementation and delivery of Video Group Consultations (VGCs). Design and Setting: Qualitative study in general practice in England. Method: 32 semi-structured interviews with patients, clinical and non-clinical staff from 8 GP surgeries, NHS policy-makers and programme managers; 3 co-design workshops (21 participants in total); and observation in training and meetings. Thematic analysis was informed by the Planning and Evaluating Remote Consulting Services (PERCS) framework. Results: In the first year of the pandemic, VGCs focused on supporting those with long-term conditions or other shared health and social needs. Most patients welcomed clinical and peer input, and the opportunity to access their practice remotely during lockdown. However, not everyone agreed to engage in group-based care or was able to access IT equipment. At practice level, significant work was needed to deliver VGCs, such as setting up the digital infrastructure, gaining team buy-in, developing new patient-facing online facilitation roles, managing background operational processes, protecting online confidentiality, and ensuring professional indemnity cover. Training provided nationally was seen as instrumental in capacity building for VGC implementation. Conclusion: Small scale VGC implementation addressed unmet need during the pandemic. However, embedding VGCs in routine care requires re-thinking of operational, infrastructural and clinical processes. Additional research on costs and benefits at service and patient level is needed.

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Section: Discussionmentioning

confidence: 86%

Implementing video group consultations in general practice during COVID-19: a qualitative study

2022

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“…We are not aware of any studies evaluating multi-/interdisciplinary care on patient satisfaction in IIH. In general, there is only one study dealing with patient satisfaction of patients with IIH, reporting a very high level of satisfaction among 49 IIH patients with a virtual group consultation offered during the SARS-CoV-2 pandemic to maintain care despite access restrictions [25]. In the present study, patients in standard care were mostly in the medium satisfaction range (between "rather satis ed" and "rather dissatis ed"), whereas the subscores for treatment relationship and accessibility/availability were between "rather dissatis ed" to "dissatis ed".…”

Section: Discussionmentioning

confidence: 99%

An interdisciplinary integrated specialized one-stop outpatient clinic for idiopathic intracranial hypertension – a comprehensive assessment of patient satisfaction

Bsteh,

Macher,

Krajnc

et al. 2024

Preprint

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Background Management of idiopathic intracranial hypertension (IIH) is complex requiring contributions from multiple specialized disciplines. In practice, this creates considerable organizational and communicational challenges. To meet those challenges, we established an interdisciplinary integrated outpatient clinic for IIH with a central coordination and a one-stop concept. Here, we aimed to evaluate effects of this one-stop concept on subjective patient satisfaction and economic outcome in patients with IIH. Methods In a retrospective cohort study, we compared the one-stop era with integrated care (IC, 1-JUL-2021 to 31-DEC-2022) to a reference group receiving standard care (SC, 1-JUL-2018 to 31-DEC-2019) regarding subjective patient satisfaction (assessed by the Vienna Patient Inventory). Multivariate binary logistic regression models were used to adjust for confounders. Results Baseline characteristics of the IC group (n = 85) and SC group (n = 81) were comparable (female: 90.6% vs. 90.1%; mean age: 33.6 vs. 32.8 years, educational level: ≥9 years of education 60.0% vs. 59.3%; located in Vienna 75.3% vs. 76.5%). Compared to SC, management within IC concept was associated with significantly higher subjective patient satisfaction with the strongest effects observed in satisfaction with treatment accessibility and availability (beta = 2.05; p < 0.001). Subgroup analyses of patients with migration background and language barrier consistently indicated stronger effects of IC in these groups. Conclusions Interdisciplinary integrated management of IIH significantly improves patient satisfaction – particularly in socioeconomically underprivileged patient groups.

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“…A large part of the literature on group consultations has so far focused on assessing potential to improve clinical outcomes for specific conditions and to influence measures such as patient 'satisfaction' (e.g. see 15,16). Although some studies provide positive findings, especially in clinical areas where patient self-care is important (e.g.…”

Section: Introductionmentioning

confidence: 99%

“…Only a small number of studies have focused (wholly or partly) on video group consultations in UK settings, including during the pandemic, and have provided insights in relation to facilitators/barriers or patient perceptions (e.g. see 16,22,23). Yet, more research is needed to understand whether and how group consultations, when provided remotely, can become embedded over time in different healthcare settings still recovering from the pandemic.…”

Section: Introductionmentioning

confidence: 99%

Evaluating video and hybrid group consultations in general practice: mixed-methods, participatory study protocol (TOGETHER 2)

Papoutsi,

Abel,

Iglesias

et al. 2024

NIHR Open Res

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Background General practice is facing an unprecedented challenge in managing the consequences of the pandemic. In the midst of a policy drive to balance remote and in-person service provision, substantial workload pressures remain, together with increasing prevalence of long-term conditions, and declining staff numbers and morale. To address these challenges, some practices in the UK have been delivering video and hybrid group consultations (VHGCs). Despite positive initial findings and enthusiasm, there are still gaps in our understanding of the influence VHGCs have on patient experience, healthcare utilisation, quality, safety, equity and affordability. Objectives To generate an in-depth understanding of VHGCs for chronic conditions in general practice, surface assumptions and sociotechnical dynamics, inform practice and extend theorisation. Methods Mixed-methods, multi-site research study using co-design and participatory methods, from qualitative, quantitative and cost-related perspectives. WP1 includes a national, cross-sectional survey on VHGC provision across the UK. In WP2 we will engage patients and general practice staff in co-design workshops to develop VHGC models with emphasis on digital inclusion and equity. In WP3 we will carry out a mixed-methods process evaluation in up to 10 GP practices across England (5 sites already running VHGCs and 5 comparison sites). Qualitative methods will include interviews, focus groups and ethnographic observation to examine the experiences of patients, carers, clinical and non-clinical NHS staff, commissioners and policy-makers. Quantitative methods will examine the impact of VHGCs on healthcare utilisation in primary and secondary care, patient satisfaction, engagement and activation. We will also assess value for money of group and individual care models from a health economics perspective. Conclusions We aim to develop transferable learning on sociotechnical change in healthcare delivery, using VHGCs as an exemplar of technology-supported innovation. Findings will also inform the design of a future study.

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The Effective Management of Idiopathic Intracranial Hypertension Delivered by In-person and Virtual Group Consultations: Results and Reflections from a Phase One Service Delivery

Cited by 7 publications

References 11 publications

Implementing video group consultations in general practice during COVID-19: a qualitative study

Implementing video group consultations in general practice during COVID-19: a qualitative study

An interdisciplinary integrated specialized one-stop outpatient clinic for idiopathic intracranial hypertension – a comprehensive assessment of patient satisfaction

Evaluating video and hybrid group consultations in general practice: mixed-methods, participatory study protocol (TOGETHER 2)

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