University of Agder, Kristiansand, Norway.
BMC Health Serv Res. 2023 Mar 30;23(1):316. doi: 10.1186/s12913-023-09309-7.
The coronavirus disease 2019 pandemic forced healthcare workers to use alternative consultation approaches. In general practice, the use of video consultations (VCs) increased manyfold as countries were locked down. This scoping review aimed to summarize scientific knowledge concerning the use of VC in general practice and focused on (1) the utilization of VC in general practice, (2) the experiences of the users of VC in general practice, and (3) how VC affected the clinical decision-making of general practitioners (GPs).
A scoping review was conducted in accordance with the methodology of Joanna Briggs Institute. Review questions were formulated to match each focus area. A three-step search strategy was employed to search scientific and gray literature sources. MEDLINE, Embase, Scopus, OpenGrey, Google Scholar, and ClinicalTrials.gov were searched from 2010 to March 11, 2021, and the search was re-run on August 18, 2021. The extracted data were deductively coded into pre-defined main themes, whereas subthemes were inductively synthesized. The data within each subtheme were analysed through descriptive content analysis and presented in a narrative synthesis.
Overall, 13 studies were included after screening 3,624 studies. Most patients were satisfied with VCs. VCs were most suitable for simpler issues, often shorter than face-to-face consultations, and were more likely to be used by younger patients. GPs enjoyed the flexibility and shorter duration of VCs; however, they felt an unsatisfactory deterioration in the GP-patient relationship. Despite the loss of clinical examination, diagnostic assessment was mostly successful, with little fear of missing serious illness. Prior clinical experience and a preexisting relationship with the patient were important factors for successful assessment via VC.
Both GPs and patients can be satisfied with VC in general practice in specific contexts, and adequate clinical decision-making is possible. However, disadvantages such as a diminishing GP-patient relationship have been highlighted, and the use of VC in non-pandemic settings is limited. The role of VC in the future of general practice remains unclear, and further research is needed on the long-term adoption of VC in general practice.
2019 年冠状病毒病大流行迫使医护人员采用替代咨询方式。在一般实践中，随着各国封锁，视频咨询 (VC) 的使用呈数倍增长。本范围综述旨在总结有关一般实践中使用 VC 的科学知识，重点关注 (1) VC 在一般实践中的利用，(2) 一般实践中 VC 用户的经验，以及 (3) VC 如何影响全科医生 (GP) 的临床决策。
按照 Joanna Briggs 研究所的方法进行范围综述。制定了审查问题以匹配每个重点领域。采用三步搜索策略搜索科学和灰色文献来源。从 2010 年到 2021 年 3 月 11 日，在 MEDLINE、Embase、Scopus、OpenGrey、Google Scholar 和 ClinicalTrials.gov 进行了搜索，并于 2021 年 8 月 18 日重新进行了搜索。提取的数据被演绎编码为预先确定的主要主题，而子主题则通过归纳综合。对每个子主题内的数据进行描述性内容分析，并以叙述性综合的形式呈现。
在筛选了 3624 项研究后，总共纳入了 13 项研究。大多数患者对 VC 感到满意。VC 最适合更简单的问题，通常比面对面咨询短，并且更可能被年轻患者使用。GP 喜欢 VC 的灵活性和较短的持续时间；然而，他们感到医患关系令人不满意。尽管失去了临床检查，但诊断评估大多成功，很少担心错过严重疾病。以前的临床经验和与患者的预先存在的关系是通过 VC 进行成功评估的重要因素。
在特定情况下，全科医生和患者都可以对一般实践中的 VC 感到满意，并且可以进行充分的临床决策。然而，已经强调了一些缺点，例如医患关系的减弱，并且在大流行环境之外，VC 的使用受到限制。VC 在一般实践中的未来作用仍不清楚，需要进一步研究一般实践中 VC 的长期采用。
