Use of telemedicine in general practice in Europe since the COVID-19 pandemic: A scoping review of patient and practitioner perspectives

Abstract

General practice is generally the first point of contact for patients presenting with COVID-19. Since the start of the COVID-19 pandemic general practitioners (GPs) across Europe have had to adopt to using telemedicine consultations in order to minimise the number of social contacts made. GPs had to balance two needs: preventing the spread of COVID-19, while providing their patients with regular care for other health issues. The aim of this study was to conduct a scoping review of the literature examining the use of telemedicine for delivering routine general practice care since the start of the pandemic from the perspectives of patients and practitioners. The six-stage framework developed by Arksey and O’Malley, with recommendations by Levac et al was used to review the existing literature. The study selection process was conducted according to the PRISMA Extension for Scoping Reviews guidelines. Braun and Clarke’s‘ Thematic Analysis’ approach was used to interpret data. A total of eighteen studies across nine countries were included in the review. Thirteen studies explored the practitioner perspective of the use of telemedicine in general practice since the COVID-19 pandemic, while five studies looked at the patient perspective. The types of studies included were: qualitative studies, literature reviews, a systematic review, observational studies, quantitative studies, Critical incident technique study, and surveys employing both closed and open styled questions. Key themes identified related to the patient/ practitioner experience and knowledge of using telemedicine, patient/ practitioner levels of satisfaction, GP collaboration, nature of workload, and suitability of consultations for telemedicine. The nature of general practice was radically changed during the COVID-19 pandemic. Certain patient groups and areas of clinical and administrative work were identified as having performed well, if not better, by using telemedicine. Our findings suggest a level of acceptability and satisfaction of telemedicine by GPs and patients during the pandemic; however, further research is warranted in this area.

Author summary

Globally, the COVID-19 pandemic imposed significant restrictions on social contact. These included practices such as social distancing and cocooning for elderly people and those with various morbidities. This resulted in general practitioners (GPs) across Europe having to adopt to using telemedicine consultations to minimise the number of social contacts made. GPs had to try to achieve a balance between preventing the spread of COVID-19 and providing their patients with regular care for other health issues. In this paper we conducted a comprehensive review of the literature to examine the use of telemedicine for delivering routine general practice care since the start of the pandemic from the perspectives of patients and practitioners. Our findings suggest a level of acceptability and satisfaction of telemedicine by GPs and patients during the pandemic. However, for doctors to be prepared to make the shift to telemedicine, they require training and education on using telemedicine as well as ensuring they are equipped with the necessary digital resources to conduct remote care.