Delivering bronchiectasis physiotherapy clinics remotely: Patient perceptions and future preferences

ABSTRACT

Background/Aims: National guidelines recommend that patients with bronchiectasis should be reviewed by specialist physiotherapists (Polverino et al., 2017). These appointments should involve teaching of individualised airway clearance techniques, promotion of exercise and education to optimise self-management. During the covid pandemic, face to face appointments were cancelled. Ways of conducting effective physiotherapy consultations remotely were required. We used telephone and video respiratory physiotherapy consultations. We assessed patient satisfaction with remote consultations and views on future modes of clinic delivery. Methods: All patients contacted for a predetermined physiotherapy clinic between 21/4/20 and 29/6/20 were asked questions regarding their consultation and preferences (Table 1). Telephone and video calls were carried out by PM. Data was collected via follow up phone calls using a pre-selected questionnaire or postal questionnaire. Data was recorded and analysed using Excel plus thematic analysis for free text responses. Results: Thirty telephone and 35 virtual consultations were offered. 12 virtual consultations were converted to telephone due to lack of internet access. Thirty-nine (60%) were new referrals, 26 (40%) were reviews. Median age was 65 (range 21-91). Median telephone call duration was 29 minutes (range 15-40). Beyond covid-19 restrictions, twenty-four (37%) preferred a virtual appointment;twenty-two (34%) telephone, four (6%) face to face consultation and fifteen (23%) had no preference. Conclusions: The majority of respondents (97%) were satisfied with remote consultation during covid restrictions. Interestingly, only 6% preferred to return to face to face (Table presented) appointments. Qualitative exploration of reasoning behind these decisions revealed two main themes convenience and practicality and medical reasons and beliefs. In our cohort, 71% of patients preferred to continue remote physiotherapy clinics. Individual preferences on format and location of care are key components of NHS plans. Our data show that patient satisfaction can be maintained with remote delivery of respiratory physiotherapy, yet more work is needed to standardise and improve remote physiotherapy interventions. In addition to patient preference, ascertaining the comparative clinical effectiveness of appointment formats in the longer term will facilitate evidence-based provision of physiotherapy resources.