11 February 2024: Review Articles
A Systematic Review of Publications on Perceptions and Management of Chronic Medical Conditions Using Telemedicine Remote Consultations by Primary Healthcare Professionals April 2020 to December 2021 During the COVID-19 Pandemic
Arzaq Ahmed 1ABCDEF , Mahdi Mutahar 2ADF* , Arwa A. Daghrery 3EFG , Nassreen H. Albar 3EFG , Ismail Qasem I. Alhadidi 4BG , Ali Mohammed Asiri 5DG* , Nezar Boreak 3BFG , Ahmed Audah S. Alshahrani 6DG , Mansoor Shariff 7CG , Mosa A. Shubayr 8CFG , Mohammed M. Al Moaleem 9EFDOI: 10.12659/MSM.943383
Med Sci Monit 2024; 30:e943383
Background
Review Design
Formulating Research Question
Keys Terms
Inclusion and Exclusion Criteria
Databases Selection and Studies Searching
Quality Assessment
Data Extraction
Data Synthesis
Results of the Selection and Search Criteria
Characteristics of the Included Studies
Heterogenicity of the Studies
Quality Appraisal of the Included Studies
Emerging Themes
Discussion
Conclusions
References
Table 3 The 4 themes and their relation to telemedicine.
| Quotations | Articles | |
|---|---|---|
| Accessible | “skip work or find a ride to come to the clinic for things you could do over telemedicine” (P6)“people seeking care sooner if they needed to, it’s more accessible” (P4) | Verhoeven et al, (2020); Crossman et al, (2020); Helou et al, (2020); Hassani et al, (2020); Srinvasan et al, (2020) |
| Convenient | “I think it’s useful for patients who live far away, have busy working lives, who are traveling, older patients” (Provider) | Crossman et al, (2020); Verhoeven et al, (2020) |
| User satisfaction – Holistic care | “it is a good wake-up call for everybody. Now we see clearly the effect of our behaviour on nature” (GP47)“I suddenly have six or seven or eight or nine minutes that I would have spent on physical exam to devote toward discussion” | Crossman et al, 2020; Hassani et al, (2020); Srinvasan et al, (2020) |
| Increased compliance | “It’s allowed us to engage with the patients that previously were having problems engaging because of either logistics or time”“patients will pick up their phone…and it’s a way to have adherence to their clinical appointment” (P2) | Verhoeven et al, (2020); Hassani et al, (2020); Srinvasan et al, (2020) |
| Cost-effectiveness | Fewer travel-related inconveniences such as traffic and parking“It avoids the patient’s travels to health centers” (S39) | Gomes et al, (2020); Aksoy et al, (2020); Rodriguez et al, (2020) |
| “It’s hard to replace the in person [visit], even if you didn’t need to examine the patient, because you appreciate a lot of the nuances, how the patient’s acting in the office and stuff that you cannot appreciate over telehealth” (P5) | Crossman et al, (2020); Hassani et al, (2020); Srinvasan et al, (2020) | |
| User resistance | “The workload is different from the usual: you need to start earlier, make a lot of phone calls, send emails in between, try to keep up to date by reading a lot, adjust your website…so you’re busy the whole day” (GP18)“Mistrust, resistance from both parties towards the use of the technology” (S34) | Rodriguez et al, (2020); Srinvasan et al, (2020); Hassani et al, (2020) |
| Legal, moral, ethical and regulation issues | “Only ethical issue is really ensuring that we are keeping the confidentiality of our patients. We need to make sure the audio is not thought to be inadvertently off, and our patients hear conversations they were not supposed to” (Nurse) | Aksoy et al, (2020); Rodriguez et al, (2020) |
| Lack of infrastructure | “Young people are using [it] fine… but for some of the elderly, it is more of a problem. I am calling my older patients who are less tech savvy” (Provider)“Some people have a problem speaking clearly, and this is probably a characteristic of their illness or just their communication style. But that can be very difficult over the phone. I sometimes have to ask people, ‘Can you speak clearly?’ or, ‘Can you just try to speak a little bit louder?’” | Hassani et al, (2020); Srinvasan et al, (2020); Crossman et al, (2020) |
| Training | “Communication skills (active listening, empathy, emotional support), motivation, creativity, conflict resolution, patience” (S35)“Active listening, communication and clinical interview skills, deferred conflict resolution, fomenting trust through this medium” (S48) | Rodriguez et al, (2020); Aksoy et al, (2020) |
| ‘Determine effectiveness, utility, and unmet needs of virtual care for patients, providers, and staff’ | Rodriguez et al, (2020); Srinvasan et al, (2020); Crossman et al, (2020) | |
| Sustainability | “I think it will be great for going forward to still have video visits because there are a lot of things, we can do over video | Hassani et al, (2020); Rodriguez et al, (2020); Srinvasan et al, (2020) |
| Implementation | “It needs more time and adequate technical skills from both parties” (S2) | Srinvasan et al, (2020); Rodriguez et al, (2020); Srinvasan et al, (2020) |
| Management of telemedicine | “Video visits are shorter, so there is less back and forth, [and] more focus” | Srinvasan et al, (2020); Hassani et al, (2020) |
| Service user’s awarenessSkills required | “For some patients, it use could be complex. For those who are older, they need the necessary support to be able to use this means of communication” (S50)“Perhaps at first, until the population is familiarized with this technique” (S26) | Crossman et al, (2020); Gomez et al, (2020); Srinvasan et al, (2020) |