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. 2022 Apr 2;23(1):312.
doi: 10.1186/s12891-022-05273-1.

Acceptability of, and preferences for, remote consulting during COVID-19 among older patients with two common long-term musculoskeletal conditions: findings from three qualitative studies and recommendations for practice

Zoe Paskins  1   2 , Laurna Bullock  3 , Fay Manning  3   4 , Simon Bishop  5 , Paul Campbell  6 , Elizabeth Cottrell  3 , G P Partner  7 , Clare Jinks  6 , Melanie Narayanasamy  8 , Ian C Scott  3   6 , Opinder Sahota  9 , Sarah Ryan  6   10
Affiliations

Acceptability of, and preferences for, remote consulting during COVID-19 among older patients with two common long-term musculoskeletal conditions: findings from three qualitative studies and recommendations for practice

Zoe Paskins et al. BMC Musculoskelet Disord. .

Abstract

Background: Guidance for choosing face-to-face vs remote consultations (RCs) encourages clinicians to consider patient preferences, however, little is known about acceptability of, and preferences for RCs, particularly amongst patients with musculoskeletal conditions. This study aimed to explore the acceptability of, and preferences for, RC among patients with osteoporosis and rheumatoid arthritis.

Methods: Three UK qualitative studies, exploring patient experiences of accessing and receiving healthcare, undertaken during the pandemic, with people with osteoporosis and rheumatoid arthritis. Study team members agreed a consistent approach to conduct rapid deductive analysis using the Theoretical Framework of Acceptability (TFA) on transcripts from each data set relating to RC, facilitated by group meetings to discuss interpretations. Findings from the three studies were pooled.

Results: Findings from 1 focus group and 64 interviews with 35 people were included in the analysis. Participants' attitudes to RC, views on fairness (ethicality) and sense-making (intervention coherence) varied according to their needs within the consultation and views of the pandemic. Some participants valued the reduced burden associated with RC, while others highly valued non-verbal communication and physical examination associated with face-to-face consults (opportunity costs). Some participants described low confidence (self-efficacy) in being able to communicate in RCs and others perceived RCs as ineffective, in part due to suboptimal communication.

Conclusions: Acceptability of, and preferences for RC appear to be influenced by societal, healthcare provider and personal factors and in this study, were not condition-dependant. Remote care by default has the potential to exacerbate health inequalities and needs nuanced implementation.

Keywords: Osteoporosis; Remote consultation; Rheumatoid arthritis; Telemedicine.

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Conflict of interest statement

The authors declare no competing interests

Figures

Fig. 1
Fig. 1
Overview of methods and analysis
Fig. 2
Fig. 2
Summary of findings relating to TFA domains
Fig. 3
Fig. 3
Recommendations for clinical practice
See this image and copyright information in PMC

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