From the Division of Female Pelvic Medicine and Reconstructive Surgery, Northwestern University, Chicago, IL.
Urogynecology (Phila). 2023 Feb 1;29(2):273-280. doi: 10.1097/SPV.0000000000001280.
The acceptability and safety of telehealth have been reported in urogynecology for preoperative and postoperative care but not new patient consultation.
This study aimed to determine if new patient telehealth encounters are noninferior to in-person encounters for women presenting to a urogynecology clinic using a satisfaction questionnaire. Secondary objectives were to describe patient experiences and follow-up.
A randomized controlled trial of telehealth versus in-person consults for new patients with any urogynecologic condition was conducted. Patients completed the validated Patient Satisfaction Questionnaire 18 (PSQ-18) after the visit. The primary outcome was composite PSQ-18 score. Using a noninferiority margin of 5 points on the PSQ-18, 25 patients per arm were required with a power of 80% and an α of 0.05.
From March to September 2021, 133 patients were screened, 71 were randomized, and 58 were included in the final analysis (30 telehealth and 28 in-person). Demographic characteristics were similar between groups. Patient Satisfaction Questionnaire 18 composite scores were high for both groups but higher for in-person versus telehealth visits (75.68 ± 8.55 vs 66.60 ± 11.80; P = 0.001; difference, 9.08); results were inconclusive with respect to noninferiority. Women in the telehealth group expressed uncertainty regarding the telehealth format. There were no differences in short-term follow-up, communication with the office, or treatment chosen between groups.
Women seen by urogynecologic providers for a new consult both via in-person or telehealth visits demonstrated high satisfaction with their first visit. We were unable to determine if telehealth is noninferior to in-person visits. Our study adds to the literature that telehealth is safe, effective, and acceptable to patients.
远程医疗在泌尿外科领域已被报道用于术前和术后护理，但不适用于新患者咨询。
本研究旨在通过满意度问卷确定新患者远程医疗就诊是否不劣于面对面就诊，以评估女性前往泌尿科诊所就诊的情况。次要目标是描述患者的就诊体验和随访情况。
一项针对任何泌尿妇科疾病的新患者的远程医疗与面对面就诊的随机对照试验。患者在就诊后完成经过验证的患者满意度问卷 18 项（PSQ-18）。主要结局是综合 PSQ-18 评分。使用 PSQ-18 的 5 分非劣效性边界，每组需要 25 名患者，具有 80%的功效和 0.05 的α值。
2021 年 3 月至 9 月期间，共筛选了 133 名患者，其中 71 名被随机分配，58 名被纳入最终分析（30 名远程医疗，28 名面对面）。两组的人口统计学特征相似。两组的患者满意度问卷 18 综合评分均较高，但面对面就诊的评分高于远程医疗就诊（75.68±8.55 与 66.60±11.80；P=0.001；差异为 9.08）；非劣效性结果不确定。远程医疗组的女性对远程医疗形式表示不确定。两组在短期随访、与办公室的沟通或治疗选择方面均无差异。
通过面对面或远程医疗就诊的泌尿科医生新就诊的女性对首次就诊均表示高度满意。我们无法确定远程医疗是否不劣于面对面就诊。我们的研究增加了远程医疗对患者安全、有效且可接受的文献证据。
