A Literature Review of Studies that Have Compared the Use of Face-To-Face and Online Focus Groups

Online communication in our work and private lives has increased significantly since the COVID-19 pandemic. Qualitative research has evolved with this trend with many studies adopting online methods. It is therefore timely to assess the use and utility of online focus groups compared to face-to-face focus groups. Traditional Pearl Growing Methodology was used to identify eligible papers. Data were extracted on data collection methods, recruitment and sampling strategies, analytical approaches to comparing data sets, the depth of data produced, participant interactions and the required resources. A total of 26 papers were included in the review. Along with face-to-face focus groups (n = 26) 16 studies conducted synchronous, eight asynchronous and two both online focus group methods. Most studies (n = 22) used the same recruitment method for both face-to-face and online focus groups. A variety of approaches to compare data sets were used in studies. Of the studies reporting on depth of data (n = 19), nine found that face-to-face groups produced the most in-depth data, four online groups and six equivalent data. Participant interaction was reported to be greater during face-to-face groups in 10 studies;three reported online groups produced greater interaction and six equivalent interaction. Detailed resource use comparisons were not presented in any of the studies. This review demonstrates that to date there is not a clear consensus as to whether face-to-face or online focus groups hold specific advantages in terms of the data produced and the resources required. Given these findings it may be appropriate for researchers to consider using online focus groups where time and resources are constrained, or where these are more practicable. [ FROM AUTHOR]

Real-time remote outpatient consultations in secondary and tertiary care: A systematic review of inequalities in invitation and uptake.

BACKGROUND: Health policies in most high income countries increasingly recommend provision of routine outpatient care via remote (video and/or telephone) appointments, especially due to the pandemic. This is thought to improve access to care and promote efficiency within resource-constrained health services. There is limited evidence about the impact on existing inequalities in the invitation and uptake of health services when remote outpatient care is offered. AIM: To systematically review the evidence on the offer and/or uptake of real-time remote outpatient consultations in secondary and tertiary care, assessed according to key sociodemographic characteristics. METHODS: Seven electronic bibliographic databases were searched for studies reporting the proportion of patients with key characteristics (following PROGRESS Plus criteria) who were offered and/or accepted real-time remote outpatient consultation for any chronic condition. Comparison groups included usual care (face-to-face), another intervention, or offer/uptake within a comparable time period. Study processes were undertaken in duplicate. Data are reported narratively. RESULTS: Twenty-nine studies were included. Uptake of video consultations ranged from 5% to 78% and telephone consultations from 12% to 78%. Patients aged over 65, with lower educational attainment, on lower household incomes and without English as a first language were least likely to have a remote consultation. Females were generally more likely to have remote consultations than males. Non-white ethnicities were less likely to use remote consultations but where they did, were significantly more likely to choose telephone over video appointments (p<0.001). CONCLUSIONS: Offering remote consultations may perpetuate or exacerbate existing health inequalities in access to healthcare. More research is needed on current health disparities by sociodemographic characteristics and to explore what works well for different patient groups and why so that processes can be designed to ameliorate these health disparities. TRIAL REGISTRATION: PROSPERO registration no: CRD42021241791.

Remote Consultations Versus Standard Face-to-Face Appointments for Liver Transplant Patients in Routine Hospital Care: Feasibility Randomized Controlled Trial of myVideoClinic.

BACKGROUND: Using technology to reduce the pressure on the National Health Service (NHS) in England and Wales is a key government target, and the NHS Long-Term Plan outlines a strategy for digitally enabled outpatient care to become mainstream by 2024. In 2020, the COVID-19 response saw the widespread introduction of remote consultations for patient follow-up, regardless of individual preferences. Despite this rapid change, there may be enduring barriers to the effective implementation of remote appointments into routine practice once the unique drivers for change during the COVID-19 pandemic no longer apply, to which pre-COVID implementation studies can offer important insights. OBJECTIVE: This study aims to evaluate the feasibility of using real-time remote consultations between patients and secondary care physicians for routine patient follow-up at a large hospital in the United Kingdom and to assess whether patient satisfaction differs between intervention and usual care patients. METHODS: Clinically stable liver transplant patients were randomized to real-time remote consultations in which their hospital physician used secure videoconferencing software (intervention) or standard face-to-face appointments (usual care). Participants were asked to complete postappointment questionnaires over 12 months. Data were analyzed on an intention-to-treat basis. The primary outcome was the difference in scores between baseline and study end by patient group for the three domains of patient satisfaction (assessed using the Visit-Specific Satisfaction Instrument). An embedded qualitative process evaluation used interviews to assess patient and staff experiences. RESULTS: Of the 54 patients who were randomized, 29 (54%) received remote consultations, and 25 (46%) received usual care (recruitment rate: 54/203, 26.6%). The crossover between study arms was high (13/29, 45%). A total of 129 appointments were completed, with 63.6% (82/129) of the questionnaires being returned. Patient satisfaction at 12 months increased in both the intervention (25 points) and usual care (14 points) groups. The within-group analysis showed that the increases were significant for both intervention (P<.001) and usual care (P=.02) patients; however, the between-group difference was not significant after controlling for baseline scores (P=.10). The qualitative process evaluation showed that-according to patients-remote consultations saved time and money, were less burdensome, and caused fewer negative impacts on health. Technical problems with the software were common, and only 17% (5/29) of patients received all appointments over video. Both consultants and patients saw remote consultations as positive and beneficial. CONCLUSIONS: Using technology to conduct routine follow-up appointments remotely may ease some of the resource and infrastructure challenges faced by the UK NHS and free up clinic space for patients who must be seen face-to-face. Our findings regarding the advantages and challenges of using remote consultations for routine follow-ups of liver transplant patients have important implications for service organization and delivery in the postpandemic NHS. TRIAL REGISTRATION: ISRCTN Registry 14093266; https://www.isrctn.com/ISRCTN14093266. INTERNATIONAL REGISTERED REPORT IDENTIFIER (IRRID): RR2-10.1186/s13063-018-2953-4.

P40 Video clinics versus standard face-to-face appointments for liver transplant patients in routine hospital care: a feasibility randomised controlled trial of myVideoClinic

IntroductionThere has recently been a rapid increase in the number of health and social care organisations offering remote consultations in order to minimise the spread of disease following the outbreak of COVID-19, but their effectiveness is unclear. The majority of studies focusing on remote consultations to date have evaluated telephone appointments. Although some studies have used video conferencing technology in the secondary care sector, the sample sizes have been small and they differ in their findings. This study evaluated the feasibility of implementing video clinics at a large hospital trust in the UK and assessed whether the intervention improved patient satisfaction compared to standard face-to-face appointments for liver transplant patients.MethodsClinically stable liver transplant patients were randomised to video clinic appointments (intervention) or standard face-to-face appointments (usual care). The intervention group had routine follow-up appointments via secure video link. Participants were asked to complete post-appointment questionnaires over 12 months. The primary outcome was the difference in scores between baseline and study end by patient group for three domains of patient satisfaction using the Visit-Specific Satisfaction Instrument (VSQ-9). An embedded qualitative process evaluation used interviews to assess patient and staff experiences.ResultsFifty four patients were randomised: 29 to receive video clinics and 25 to usual care (recruitment rate 26.6%). Crossover from intervention to usual care was high (44.8%). 129 appointments were completed with 64% of questionnaires returned. Patient satisfaction (intention-to-treat analysis) increased in both intervention and usual care groups but the between-group difference was not significant after controlling for baseline scores. Video appointments were perceived to save patients time and money, and patients found video clinics to be less burdensome, with fewer negative impacts on their health. Technical problems with the software were common, however, the software is constantly evolving and as time goes on these types of problems should ease. Both clinicians and patients saw video clinic appointments as positive and beneficial.DiscussionThe UK National Health Service is facing huge challenges with regards to staffing, budgets and space due to increasing patient numbers. Being innovative by using available technology to offer routine follow-up appointments via secure video link may help ease some of the burdens and free up clinic space for those patients who need to be seen face-to-face. This study outlines our experiences of using a remote video consultation system and the associated advantages and pitfalls.