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2019年冠状病毒病大流行期间银屑病关节炎患者对远程医疗预约的看法:一项患者主导的试点调查结果

Patients' perspectives of telemedicine appointments for psoriatic arthritis during the COVID-19 pandemic: results of a patient-driven pilot survey.

作者信息

Jethwa Hannah, Brooke Melanie, Parkinson Andrew, Dures Emma, Gullick Nicola J

机构信息

Department of Rheumatology, Hammersmith Hospital, 72 Du Cane Road, London, W12 0HS, UK.

, Bath, UK.

出版信息

BMC Rheumatol. 2022 Feb 22;6(1):13. doi: 10.1186/s41927-021-00242-y.

Abstract

BACKGROUND

Over recent years the lack of patient involvement in the design, set-up and implementation of clinical research studies has been well recognised; as such there has been a drive within research communities to increase patient participation. Patient perspectives on telemedicine differ widely, with variation in whether patients feel remote consultations are beneficial. By means of a patient-driven survey, we aimed to formally evaluate patient perspectives on its benefits and pitfalls, focusing on patients with psoriatic arthritis (PsA).

METHODS

An e-survey was developed by two patient representatives on the BritPACT steering committee, with a view to determining unmet needs and the perceived impact on clinical care of virtual consultations amongst patients with PsA.

RESULTS

128 patients responded to the e-survey. 109 patients rated the effectiveness of their telemedicine appointment and, of these, 18% felt their virtual consultation was very/extremely effective compared to an in-clinic consultation and 49% felt it was somewhat/equally as effective; furthermore, 48% (51/107) felt that such virtual consultations would be of benefit to them after the pandemic. 36% of respondents felt their virtual consultation was not as effective as an in-clinic review. Themes identified from open-ended questions included the lack of visual cues, lack of physical examination and effect on rapport and ease of open communication as the main pitfalls of virtual consultations. Patients with well-controlled symptoms appeared more satisfied with remote reviews compared to those with active disease, though on the whole respondents recognised the benefits, such as saving travel time and costs. Those who had an established relationship with their health professional appeared less concerned regarding virtual consultations though a recurring view was that newly diagnosed patients should have in-clinic appointments to build rapport and improve symptom control at an early stage.

CONCLUSIONS

Overall patients' perspectives on virtual consultations varied widely though patients with well-controlled symptoms and those who had a previously established relationship with their healthcare professionals and well-controlled disease appeared more satisfied with remote reviews.

摘要

背景

近年来,临床研究的设计、筹备及实施过程中缺乏患者参与的问题已得到广泛认识;因此,研究界一直在努力提高患者的参与度。患者对远程医疗的看法差异很大,对于远程会诊是否有益存在不同观点。通过一项由患者主导的调查,我们旨在正式评估患者对远程医疗的益处和弊端的看法,重点关注银屑病关节炎(PsA)患者。

方法

英国银屑病关节炎临床试验(BritPACT)指导委员会的两名患者代表开展了一项电子调查,旨在确定未满足的需求以及PsA患者对虚拟会诊临床护理的感知影响。

结果

128名患者回复了电子调查。109名患者对其远程医疗预约的有效性进行了评分,其中18%的患者认为与门诊会诊相比,他们的虚拟会诊非常/极其有效,49%的患者认为其有些/同样有效;此外,48%(51/107)的患者认为这种虚拟会诊在疫情后对他们有益。36%的受访者认为他们的虚拟会诊不如门诊复查有效。从开放式问题中确定的主题包括缺乏视觉线索、缺乏体格检查以及对融洽关系和开放沟通便利性的影响,这些是虚拟会诊的主要弊端。与疾病活动期的患者相比,症状得到良好控制的患者似乎对远程复查更满意,不过总体而言,受访者认识到了远程医疗的益处,比如节省出行时间和费用。与健康专业人员建立了关系的患者对虚拟会诊的担忧似乎较少,不过一个反复出现的观点是,新确诊的患者应该进行门诊预约,以便在早期建立融洽关系并改善症状控制。

结论

总体而言,患者对虚拟会诊的看法差异很大,不过症状得到良好控制的患者以及那些之前与医疗保健专业人员建立了关系且疾病得到良好控制的患者似乎对远程复查更满意。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/149e/8862260/39a0a2c1c463/41927_2021_242_Fig1_HTML.jpg

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