scholarly journals Examining GP online consultation in a primary care setting in east midlands, UK

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Dewy Nijhof ◽  
Andy Ingram ◽  
Rebecca Ochieng ◽  
Emma-Jane Roberts ◽  
Barnaby Poulton ◽  
...  
Keyword(s):  
Primary Care ◽  
Health Condition ◽  
Care Services ◽  
Online Consultation ◽  
Primary Care Services ◽  
East Midlands ◽  
Consultation System ◽  
Exploratory Data ◽  
Age Range

Abstract Background Increasing pressure threatens to overwhelm primary care services, affecting the quality of care and their role as gatekeepers to specialised care services. This study investigated healthcare users’ acceptability of – and the effectiveness of – an e-consultation system in primary care services. Methods Seven GP practices in East-Midlands, all of whom use online consultation system participated in the study, with a retrospective review being undertaken of 189 electronic patients’ records (age range of 18–76 years) over 5 months. The focus was on the electronic records of patients who accessed the service for five different conditions identified as presenting common conditions seen by the GPs practices. Statistical analysis was done using SPSS to perform an exploratory data analysis and descriptive statistics. Results The results showed a positive reception of the online consultation platform, with an average satisfaction score of 4.15 (most likely to recommend score = 5). Given the nature of the conditions, 47.6% of patients had experienced a previous episode of the health condition they were seeking consultation for, and a total of 72% had existing comorbidities. Follow-up activity occurred for 87.3% of patients, 66.1% of which included at least one follow-up visit for the same condition as the initial online consultation. Conclusion The results suggest that online consultation is convenient for patients, and it also has the potential to relieve pressure placed on primary care services. Although a number of challenges were identified, such as patient verification, this study gives insight into – and enhances our understanding of – the use of online GP consultations.

scholarly journals Comparing the content and quality of video, telephone, and face-to-face consultations: a non-randomised, quasi-experimental, exploratory study in UK primary care

2019 ◽  
Vol 69 (686) ◽  
pp. e595-e604 ◽  
Author(s):  
Victoria Hammersley ◽  
Eddie Donaghy ◽  
Richard Parker ◽  
Hannah McNeilly ◽  
Helen Atherton ◽  
...  
Keyword(s):  
Primary Care ◽  
General Practice ◽  
Technical Problems ◽  
Face To Face ◽  
Information Giving ◽  
Care Services ◽  
Primary Care Services ◽  
Quasi Experimental ◽  
Primary Care Clinicians

BackgroundGrowing demands on primary care services have led to policymakers promoting video consultations (VCs) to replace routine face-to-face consultations (FTFCs) in general practice.AimTo explore the content, quality, and patient experience of VC, telephone (TC), and FTFCs in general practice.Design and settingComparison of audio-recordings of follow-up consultations in UK primary care.MethodPrimary care clinicians were provided with video-consulting equipment. Participating patients required a smartphone, tablet, or computer with camera. Clinicians invited patients requiring a follow-up consultation to choose a VC, TC, or FTFC. Consultations were audio-recorded and analysed for content and quality. Participant experience was explored in post-consultation questionnaires. Case notes were reviewed for NHS resource use.ResultsOf the recordings, 149/163 were suitable for analysis. VC recruits were younger, and more experienced in communicating online. FTFCs were longer than VCs (mean difference +3.7 minutes, 95% confidence interval [CI] = 2.1 to 5.2) or TCs (+4.1 minutes, 95% CI = 2.6 to 5.5). On average, patients raised fewer problems in VCs (mean 1.5, standard deviation [SD] 0.8) compared with FTFCs (mean 2.1, SD 1.1) and demonstrated fewer instances of information giving by clinicians and patients. FTFCs scored higher than VCs and TCs on consultation-quality items.ConclusionVC may be suitable for simple problems not requiring physical examination. VC, in terms of consultation length, content, and quality, appeared similar to TC. Both approaches appeared less ‘information rich’ than FTFC. Technical problems were common and, though patients really liked VC, infrastructure issues would need to be addressed before the technology and approach can be mainstreamed in primary care.

scholarly journals Management of Low back pain in Saudi Arabia healthcare system. A Qualitative Study

2021 ◽  
Vol 58 ◽  
pp. 004695802110601
Author(s):  
Ahmed S. Alhowimel ◽  
Faris A. Alodaibi ◽  
Mazyad A. Alotaibi ◽  
Dalyah M. Alamam ◽  
Julie Fritz
Keyword(s):  
Primary Care ◽  
Saudi Arabia ◽  
Low Back Pain ◽  
Back Pain ◽  
Pain Management ◽  
Low Back ◽  
Care Services ◽  
Primary Care Services ◽  
Age Range ◽  
Back Pain Management

Background Patients with chronic low back pain can contribute to a global socioeconomic burden. Current international recommendations emphasize that low back pain management should occur at the primary-care level. However, there is a lack of essential services for low back pain management at the primary-care level in Saudi Arabia. We explored the current state of low back pain management in Saudi Arabia from the perspective of spine surgeons and physiotherapists. Methods A qualitative study with semi-structured interviews was conducted on spine surgeons and physiotherapists. A total of 17 healthcare workers, 8 spine surgeons (age range 28–49 years) and 9 physiotherapists (age range 30–49 years) participated in the study. Data were recorded and analyzed thematically. Results Three main themes were identified from the interview data that outlined current low back pain management in Saudi Arabia: clinical guideline availability and pathways of care, utilization of primary care services, and overutilization of secondary care resources. Conclusions This study suggests underutilization of primary care services and overutilization of secondary care services in Saudi Arabia. Therefore, the implementation of local clinical guidelines could improve patient care as well as reduce the cost of low back pain management.

scholarly journals The Seniors’ Community Hub: An Integrated Model of Care for the Identification and Management of Frailty in Primary Care

Geriatrics ◽  
2021 ◽  
Vol 6 (1) ◽  
pp. 18
Author(s):  
Marjan Abbasi ◽  
Sheny Khera ◽  
Julia Dabravolskaj ◽  
Bernadette Chevalier ◽  
Kelly Parker
Keyword(s):  
Primary Care ◽  
Gait Speed ◽  
Family Physicians ◽  
Community Dwelling ◽  
Integrated Models ◽  
Care Services ◽  
Interprofessional Teamwork ◽  
Team Working ◽  
Centered Care

(1) Background: Integrated models of primary care deliver the comprehensive and preventative approach needed to identify and manage frailty in older people. Seniors’ Community Hub (SCH) was developed to deliver person-centered, evidence-informed, coordinated, and integrated care services to older community dwelling adults living with frailty. This paper aims to describe the SCH model, and to present patient-oriented results of the pilot. (2) Methods: SCH was piloted in an academic clinic with six family physicians. Eligible patients were community dwelling, 65 years of age and older, and considered to be at risk of frailty (eFI > 0.12). Health professionals within the clinic received training in geriatrics and interprofessional teamwork to form the SCH team working with family physicians, patients and caregivers. The SCH intervention consisted of a team-based multi-domain assessment with person-centered care planning and follow-up. Patient-oriented outcomes (EQ-5D-5L and EQ-VAS) and 4-metre gait speed were measured at initial visit and 12 months later. (3) Results: 88 patients were enrolled in the pilot from April 2016–December 2018. No statistically significant differences in EQ-5D-5L/VAS or the 4-metre gait speed were detected in 38 patients completing the 12-month assessment. (4) Conclusions: Future larger scale studies of longer duration are needed to demonstrate impacts of integrated models of primary care on patient-oriented outcomes for older adults living with frailty.

scholarly journals Screening Neurocognitive Disorders in Primary Care Services: The Quick Mild Cognitive Impairment Approach

2020 ◽  
Vol 4 (Supplement_1) ◽  
pp. 158-158
Author(s):  
Constanca Paul ◽  
Susana Sousa ◽  
Pedro Santos ◽  
Rónán O’Caoimh ◽  
William Molloy
Keyword(s):  
Mental Health ◽  
Primary Care ◽  
Cognitive Impairment ◽  
Community Sample ◽  
Neurocognitive Disorders ◽  
Cognitive Status ◽  
Health Concerns ◽  
Care Services ◽  
Primary Care Services ◽  
Mental Health Concerns

Abstract Neurocognitive Disorders (NCD) is an increasingly common condition in the community. The General Practitioner (GP) in Primary Care Services (PCS), have a crucial role in early detection of NCD and is usually the first professional to detect the signs of MCI. The objective of this study was to test the feasibility and utility of the cognitive screening instrument QMCI in Primary Care. A community sample of 436 people 65+ living in the community was randomly selected from a larger group of old people with mental health concerns (N=2734), referred by their GPs. The mean age of the sample was 75.2 years (sd 7.2), with 41.3% men and 58.7% women; 60.4% married followed by 28.7% widows. The education level was low with 21% illiterate and 69,8% people with 4 years education. The QMCI mean was 37.1/100 (sd 16.2). The amount of people screening positive for cognitive impairment QMCI (<62/100) was 94.2%. In the distribution of people with cognitive impairment by Global Deterioration Scale (GDS) three recoded categories, of the 286 people 76,1% where classified as having very mild or mild impairment, 19,4% moderate or moderately serious and 4,5% severe or very severe impairment. These results confirm the perception of GPs about their clients having mental health concerns and the ability of QMCI accurately discriminate MCI. The QMCI is very brief (3-5mins) fitting the short time of GPs to assess cognitive status and timely refer clients to nonpharmacological interventions that could postpone NCD symptoms.

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