Dataset Information

Older patients' experiences of access to and use of e-consultations with the general practitioner in Norway: an interview study.

ABSTRACT:

Objective

To explore older patients' experiences with accessing and using e-consultations to send text-based clinical inquiries to the general practitioner (GP) online.

Design

Qualitative study based on semi-structured interviews. Results were analysed through a six-phase thematic analysis and interpreted through Levesque's framework of patient-centred access to health care.

Setting

General practice in Norway.

Subjects

Patients aged over 65 years (n = 16) with experience in using e-consultations.

Results

Respondents considered e-consultations as an integrated part of general practice which helped them achieve better access to health care. We identified four themes describing older patients' access to and use of e-consultations: 1) the importance of digital health literacy to learn about and use the service - and the fear of losing it, 2) the high availability of the service as the main advantage, due to the perceived unavailability of physical GP services, 3) the importance of voluntary use of e-consultations, 4) the importance of a trusting relationship with the GP.

Implications

Information about e-consultations and guidelines for suitable use are recommended to ensure equal access to all patients, regardless of their digital health literacy. Availability problems and high work burdens for the GPs could affect the patients' choice for using e-consultations. If e-consultations are used for triage purposes, caution should be taken to avoid a shift in workload from the health secretary to the GP.Key points of articleThe extended use of e-consultations with the general practitioner has raised concerns that the service may not be accessible and suitable for older patients.For older users, e-consultations can represent a positive addition to physical consultation forms due to the high availability of the service in a general practice setting characterised by long waiting times.Digital health literacy is essential to learn about and use the service. Information about the service and how to use it should be available to all patients to ensure equal access.A trusting relationship with the GP is described as essential for older patients to perceive the outcome of e-consultations as appropriate and safe.

SUBMITTER: Kristiansen E

PROVIDER: S-EPMC10088919 | biostudies-literature | 2023 Mar

REPOSITORIES: biostudies-literature

ACCESS DATA

Publications

Older patients' experiences of access to and use of e-consultations with the general practitioner in Norway: an interview study.

Kristiansen Eli E Atherton Helen H Austad Bjarne B Bergmo Trine T Norberg Børge Lønnebakke BL Zanaboni Paolo P

Scandinavian journal of primary health care 20230102 1

<h4>Objective</h4>To explore older patients' experiences with accessing and using e-consultations to send text-based clinical inquiries to the general practitioner (GP) online.<h4>Design</h4>Qualitative study based on semi-structured interviews. Results were analysed through a six-phase thematic analysis and interpreted through Levesque's framework of patient-centred access to health care.<h4>Setting</h4>General practice in Norway.<h4>Subjects</h4>Patients aged over 65 years (<i>n</i> = 16) with ...[more]

PMID: 36592342

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Project description:ObjectivesTo explore patients' use and experiences with four digital health services implemented in Norway to enable electronic communication between patients and their general practitioner (GP): (1) electronic booking of appointments; (2) electronic prescription renewal; (3) electronic contact with the GP's office for non-clinical inquiries; and (4) e-consultation for clinical inquiries.DesignAn online survey consisting of quantitative data supplemented by qualitative information was conducted to explore: (1) characteristics of the users; (2) use; (3) experiences, perceived benefits and satisfaction; and (4) time spent using the digital health services.SettingPrimary care.Participants2043 users of the digital health services answering the survey.ResultsThere was a higher proportion of women, younger adults and digitally active citizens with high education. Electronic booking of appointments was the most used service (66.4%), followed by electronic prescription renewal (54.3%). Most users (80%) could more easily and efficiently book an appointment electronically than by phone. Over 90% of the respondents thought that it was easier to renew a prescription electronically, 76% obtained a better overview of their medications and 46% reported higher compliance. For non-clinical inquiries, most respondents (60%) thought that it was easier to write electronic messages than communicate by phone. For clinical enquiries, many patients agreed that e-consultation could lead to a better followup (72%) and improved quality of treatment (58%). Users were highly satisfied with the services and recommended their use to others. Time saving was the most evident benefit for patients. This was confirmed by the differences in time spent using the digital health services compared with conventional approaches, all found to be statistically significant.ConclusionCitizens using e-consultation and other digital health services with their GP in Norway are satisfied and consider them as useful and efficient alternatives to conventional approaches.

Project description:ObjectiveAssess whether engagement in a range of cultural activities, both 'passive' and 'active' (ie, receptive and creative) participation, is associated with later demand for general practitioner (GP) consultations.DesignLongitudinal prospective cohort study.SettingData from the population-based the third Survey of Trøndelag Health Study (2006-2008) in Norway was linked to an administrative register including service information from all GP offices nationwide.ParticipantsThis study included 17 396 (54.6%) women and 14 451 (45.4%) men aged 30-79 years.Main outcome measuresMultilevel negative binomial regression models assessed the relationship between cultural engagement and GP consultations, and reported as rate ratios.ResultsA mean of 3.57 GP visits per patient was recorded during the 7 years of follow-up. Participation in creative activities and a combination of both receptive and creative activities was associated with lower number of GP consultation. Gender-specific analyses suggest that these effects were attributable to men. The rate ratio of GP consultations among men taking part in creative activities less than once, twice and more than twice (<9 times) per week is 0.90, 0.89 and 0.87 times lower, respectively, compared with non-participants. Whereas weekly frequency of receptive and creative activity engagement showed a 0.92, 0.87 and 0.83 times lower rate ratio among engaged men. The variety of activities shows a similar pattern and participation in creative activities lowers the rate ratio among men. Engagement in a wide range/variety of activities, compared with non-engagement, was associated with lower numbers of GP consultations in men, but not women.ConclusionsEngagement in creative or combined receptive and creative cultural activities was associated with lower numbers of GP consultations among men. Thus, facilitating and promoting a culturally engaged lifestyle, particularly in men, may affect primary healthcare use. However, this study design gives no evidence of a causal relationship between cultural engagement and use of GP consultations.

Project description:Backgrounde-Consultations, defined as asynchronous text-based messaging, have transformed how patients interact with their general practitioner (GP). While e-consultations can improve patient access to GP care, concerns about increased workload for GPs are raised.ObjectiveThis study aimed to address three research questions: (1) For what purpose and with what expectations do patients initiate e-consultations? (2) If e-consultations had not been available, what alternative actions would the patient have taken? and (3) How are the alternative actions associated with patient and e-consultation characteristics?MethodsA cross-sectional study was conducted through a web-based survey on Helsenorge. Helsenorge is the national citizen portal for digital health services in Norway, including e-consultations with the GP. All users who sent e-consultations through Helsenorge were invited to participate between January and February 2023. The survey addressed questions on users' expectations and experience with e-consultations. The association between patient and e-consultation characteristics and alternative actions to e-consultations were analyzed using multinomial logistic regression.ResultsOverall, 13,011 users answered the survey. The most common reason for initiating an e-consultation was requesting a sick certificate (4940/13,011, 38%). Overall, 68.7% (8802/13,011) of respondents expected an answer within 24 hours, and 17.7% (2310/13,011) anticipated that the GP would ask them to attend a physical examination. If e-consultations had not been available, 45.5% (5917/13,011) of respondents would have booked a GP appointment, and 44.9% (5846/13,011) would have called the front desk. Users who expected a quicker response (odds ratio [OR] 1.64, 95% CI 1.46-1.85) and were less concerned about their health issues (OR 1.29, 95% CI 1.18-1.40) were more likely to call the front desk. Only 2.5% (323/13,011) of respondents would have contacted out-of-hours services. Users with longer travel time to the GP office (OR 6.08, 95% CI 3.46-10.66) and with a new health problem (OR 2.71, 95% CI 2.09-3.51) were more likely to choose this option. In addition, 4.7% (609/13,011) of the users would not have sought help if e-consultations had not been available. Younger patients (OR 2.16, 95% CI 1.38-3.37) and those with a longer travel time to the GP office (OR 2.19, 95% CI 1.27-3.80) or a new health issue (OR 1.74, 95% CI 1.43-2.12) had higher odds for not seeking help.Conclusionse-Consultations were often the patients' first choice of access route, and users expected a fast response. e-Consultations were mostly perceived as an alternative to GP appointments or calling the front desk. Patients with lower availability to the GP office had higher odds of using e-consultations as an alternative to out-of-hours service or waiting and not seeking GP care. Guidance for patient use should be developed to ensure appropriate and safe use. Further research should assess the effect of e-consultations on health outcomes and efficiency.

Project description:BackgroundPatients' relationship with their GPs is linked to adherence, patient behaviour and satisfaction with healthcare. Several factors pertaining to this relationship have already been identified, however expectations and preferences vary depending on age and diagnosis. Chronically ill elderly patients constitute a group of patients with specific needs that are not yet understood.MethodsFor this observational study, 100 (44 female, mean age 72.72 + - 8.28 years) patients were interviewed. Multiple linear or binary logistic regression as well as analysis of variance was used to understand the link between factors pertaining to GP relationship and patient behaviour, and principal component analysis was performed to understand the underlying structure of patients' needs.ResultsPatients attribute high importance to their GP's opinion of them. On average, what the GP thinks about the patients is almost as important as what their partners think. Patients primarily want to be perceived as engaged, friendly and respected individuals, and it is important for patients to be liked by their GP. This importance is linked to active preparation; 65% of the patients prepared actively for GP consultations. Expectations regarding GP consultations can be split into two components: a medical aspect with a subfactor concerning emotional support, and a social component. Prominent factors influencing the relationship are the possibility to talk about emotions and mental well-being, trust, and GP competency. Satisfaction and trust were mainly linked to medical competency. Being able to show emotions or talk about mental well-being enhances perceived GP competence, satisfaction, and active patient preparation. However, a focus on the social component such as frequent talking about private topics reduces both perceived GP competency as well as active patient preparation.ConclusionOlder patients take GP consultations seriously, and their expectations regarding GP consultations focus on medical competence and care as well as empathetic listening and understanding. Older persons seek a deeper connection to their GPs and are willing to be active and cooperative. As the patient-GP relationship influences health outcomes, treatment of older patients should be adjusted to enable this active participation.

Dataset Information

Older patients' experiences of access to and use of e-consultations with the general practitioner in Norway: an interview study.

Objective

Design

Setting

Subjects

Results

Implications

Publications

Older patients' experiences of access to and use of e-consultations with the general practitioner in Norway: an interview study.

Similar Datasets

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