Sahni Manroy, Choudhry Jamaal, Mittal Ankush, Bhogal Gurjit
Family Medicine, Royal Wolverhampton NHS Trust, Wolverhampton, GBR.
Orthopaedics, Royal Wolverhampton NHS Trust, Wolverhampton, GBR.
Cureus. 2021 May 18;13(5):e15084. doi: 10.7759/cureus.15084.
Background and objective The coronavirus disease 2019 (COVID-19) pandemic has accelerated the shift towards remote consultations in the medical field, including musculoskeletal (MSK) appointments. General practitioner (GP) registrars are now routinely conducting many MSK consultations remotely; however, very little is known of their level of confidence and satisfaction regarding this new and evolving scenario, or how this may impact patient management of patients. In this study, we aimed to understand GP registrars' level of confidence and satisfaction with respect to remote MSK consultations, and the perceived impact on patient management. Study design This study involved a cross-sectional online survey of GP registrars in the West Midlands, which was conducted in January 2021. Methods The survey asked for ranked responses to questions comparing face-to-face consulting methods with remote consulting, focusing on confidence, satisfaction, onward investigations, and referral activity. Statistical analysis was performed using the R software version 4.0.3. Results The overall survey response was 21.2% (n=312/1,471). Of the respondents, 85.9% of GP registrars had not received any training to prepare them for remote MSK consultations. GP registrars generally felt that they were more confident when treating patients face-to-face compared to remote consultations (p<0.001). This was true for general MSK complaints as well as specific assessments of the hand, shoulder, spine, hip, knee, and ankle; 36.2% of GP registrars were not satisfied and 51.0% thought that their patients were not satisfied with the current quality of remote MSK consultations. Of note, 77.6% of GP registrars said that they were more likely to request additional investigations, and 75.6% stated that they were more likely to refer patients to a specialist after a remote MSK consultation. Conclusion This study highlights the need for further training to better equip primary care doctors for remote MSK consultations. With tailored training, GP registrars could offer more streamlined remote patient care for MSK complaints.
背景与目的 2019年冠状病毒病(COVID-19)大流行加速了医学领域向远程会诊的转变,包括肌肉骨骼(MSK)门诊。全科医生(GP)住院医师现在经常进行许多远程MSK会诊;然而,对于他们在这种新的不断发展的情况下的信心水平和满意度,或者这可能如何影响患者管理,人们知之甚少。在本研究中,我们旨在了解GP住院医师对远程MSK会诊的信心水平和满意度,以及对患者管理的感知影响。研究设计 本研究涉及2021年1月对西米德兰兹郡的GP住院医师进行的横断面在线调查。方法 该调查要求对将面对面会诊方法与远程会诊进行比较的问题给出排序后的回答,重点关注信心、满意度、进一步检查和转诊活动。使用R软件版本4.0.3进行统计分析。结果 总体调查回复率为21.2%(n = 312/1471)。在受访者中,85.9%的GP住院医师没有接受过任何为远程MSK会诊做准备的培训。与远程会诊相比,GP住院医师普遍认为他们在面对面治疗患者时更有信心(p<0.001)。对于一般的MSK主诉以及对手、肩、脊柱、髋、膝和踝关节的具体评估都是如此;36.2%的GP住院医师不满意,51.0%的人认为他们的患者对当前远程MSK会诊的质量不满意。值得注意的是,77.6%的GP住院医师表示他们更有可能要求进行额外检查,75.6%的人表示在远程MSK会诊后他们更有可能将患者转诊给专科医生。结论 本研究强调需要进一步培训,以使初级保健医生更好地胜任远程MSK会诊。通过量身定制的培训,GP住院医师可以为MSK主诉提供更简化的远程患者护理。