Remote asthma reviews: scoping advice and identifying the benefits and challenges from the perspective of professionals and patients.

The problem:

COVID has seen remote consultations (telephone, videocalls, and on-line) in general practice becoming the norm; these are likely to be a feature of primary care management of long-term conditions beyond the pandemic. 

Approach:

We carried out an online search, identifying guidance using a combination of the search terms ‘remote consultations’, ‘health care professional’, ‘general practitioners’ and ‘nursing’, the results of which would inform the development of a toolkit for remote asthma reviews in primary care.  We held discussions with the IMP2ART Professional Advisory Group (PAG) and Patient and Public Involvement (PPI) group to explore their perceptions of the benefits and challenges of carrying out remote asthma reviews in primary care. Discussions were recorded with consent, and notes made.

Web-based guidance was identified from NHS sources, GMC, BMA, MDU and Royal Colleges.  Resources were both document and video format with a consistency of themes.   Key themes included practical advice on using technology; ethical/legal issues; communication strategies; planning and patient selection.  The guidance focused on acute consultations only.

The Learning:

Following in-depth discussion with both groups, using these themes to guide us, we were able to gain insight into the perceived challenges and benefits of remote consultations.

The PPI group felt remote consultations were effective if participants are well-prepared but were more cautious about potential disruption to continuity of care, digital inequity and highlighted the need to respect patient preference for mode of consultation.  The PAG were less concerned about technological issues, but identified future training needs for practice staff to carry out remote asthma reviews.

Why it matters:

Current guidance can be adapted to advise professionals carrying out remote asthma reviews in primary care.  Patients and professionals were generally positive about remote reviews for asthma, but identified some concerns which will inform the design of review-specific tools for the IMP2ART toolkit.

Funding: 

This abstract presents independent research funded by the National Institute for Health

Research (NIHR) under its Programme Grants for Applied Research Programme (Ref: RP-PG-

1016-20008). The views expressed are those of the authors and not necessarily those of the

NIHR

Delaney B1; b.delaney@sheffield.ac.uk,

 Barat A2; a.barat@qmul.ac.uk  

Taylor S2; s.j.c.taylor@qmul.ac.uk

Marsh V3; vmarsh2@exseed.ed.ac.uk

 McClatchey K3; kirstie.mcclatchey@ed.ac.uk

 Kinley E3 E.J.Kinley@sms.ed.ac.uk,

Pinnock H3 Hilary.Pinnock@ed.ac.uk, for the IMP2ART group

Affiliations: 1) University of Sheffield; 2) Queen Mary University of London; 3) University of Edinburgh