Clinician and patient experience of neurology telephone consultations during the COVID-19 pandemic
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Abstract
Background
Telephone consultations are already employed in specific neurological settings. At Cambridge University Hospitals, the COVID-19 pandemic initially prompted almost all face-to-face appointments to be delivered by telephone, providing a uniquely unselected population to assess.
Objectives
We explored patient and clinician experience of telephone consultations; and whether telephone consultations might be preferable for preidentifiable subgroups of patients after the pandemic.
Methods
Clinicians delivering neurological consultations converted to telephone between April and July 2020 were invited to complete a questionnaire following each consult (430 respondents) and the corresponding patients were subsequently surveyed (290 respondents). The questionnaires assessed clinician and patient goal achievement (and the reasons for any dissatisfaction). Clinicians also described consultation duration (in comparison to face to face) while patients detailed comparative convenience and preference.
Results
The majority of clinicians (335/430, 78%) and patients (227/290, 78%) achieved their consultation goals by telephone, particularly during follow-up consultations (clinicians 272/329, 83%, patients 176/216, 81%) and in some disease subgroups (eg, seizures/epilepsy (clinicians 114/122 (93%), patients 71/81 (88%)). 95% of telephone consultations were estimated to take the same or less time than an equivalent face-to-face consultation. Most patients found telephone consultations convenient (69%) with 149/211 (71%) indicating they would like telephone or video consultations to play some role in their future follow-up.
Conclusion
Telephone consultations appear effective, convenient and popular in prespecified subgroups of neurological outpatients. Further work comparing telephone, video and face-to-face consultations across multiple centres is now needed.
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SciScore for 10.1101/2021.09.26.21264141: (What is this?)
Please note, not all rigor criteria are appropriate for all manuscripts.
Table 1: Rigor
Ethics not detected. Sex as a biological variable not detected. Randomization not detected. Blinding not detected. Power Analysis not detected. Table 2: Resources
No key resources detected.
Results from OddPub: We did not detect open data. We also did not detect open code. Researchers are encouraged to share open data when possible (see Nature blog).
Results from LimitationRecognizer: We detected the following sentences addressing limitations in the study:Our findings are also in line with the approach outlined by NHS England/National Institute of Clinical Excellence (NICE) suggesting that remote consultations are more appropriate for consultations of chronic, stable patients, where a physical examination …
SciScore for 10.1101/2021.09.26.21264141: (What is this?)
Please note, not all rigor criteria are appropriate for all manuscripts.
Table 1: Rigor
Ethics not detected. Sex as a biological variable not detected. Randomization not detected. Blinding not detected. Power Analysis not detected. Table 2: Resources
No key resources detected.
Results from OddPub: We did not detect open data. We also did not detect open code. Researchers are encouraged to share open data when possible (see Nature blog).
Results from LimitationRecognizer: We detected the following sentences addressing limitations in the study:Our findings are also in line with the approach outlined by NHS England/National Institute of Clinical Excellence (NICE) suggesting that remote consultations are more appropriate for consultations of chronic, stable patients, where a physical examination may not be required.[8] It also provides the beginnings of an evidence base for which hospitals can start adapting to digital health clinics as part of the pre-pandemic NHS Long Term Plan to move up to a third of visits non face-to-face.[20] A number of limitations are worth addressing. Foremostly, many presentations or diagnoses are under-represented, reflecting the finite period when unselected referrals were converted to telephone clinics (following which a more judicious approach based on clinician experience was adopted). Additionally, the peripheral nerve service did not undertake telephone consultations due to the importance of the clinical examination to their clinical assessments; the small number of neuropathies included here were those from general clinics so are not generalisable. The majority of patient questionnaires were collected by telephone rather than written, but we found no meaningful difference between the rates of patient-reported goal achievement or patient’s future consultation medium preference between the two approaches suggesting this methodological issue did not introduce bias. To improve uptake and avoid unnecessary burden we relied on self-reported consultation duration from clinicians which may...
Results from TrialIdentifier: No clinical trial numbers were referenced.
Results from Barzooka: We did not find any issues relating to the usage of bar graphs.
Results from JetFighter: We did not find any issues relating to colormaps.
Results from rtransparent:- Thank you for including a conflict of interest statement. Authors are encouraged to include this statement when submitting to a journal.
- Thank you for including a funding statement. Authors are encouraged to include this statement when submitting to a journal.
- No protocol registration statement was detected.
Results from scite Reference Check: We found no unreliable references.
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