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A qualitative investigation into the results of a discrete choice experiment and the impact of COVID-19 on patient preferences for virtual consultations

A qualitative investigation into the results of a discrete choice experiment and the impact of COVID-19 on patient preferences for virtual consultations
A qualitative investigation into the results of a discrete choice experiment and the impact of COVID-19 on patient preferences for virtual consultations

Objectives: to conduct a qualitative investigation on a subset of participants from a previously completed Discrete Choice Experiment (DCE) to understand why factors identified from the DCE are important, how they influenced preference for virtual consultations (VC) and how COVID-19 has influenced preference for VC.

Methods: a  quota sample was recruited from participants who participated in our DCE. We specifically targeted participants who were strongly in favour of face-to-face consultations (F2F - defined as choosing all or mostly F2F in the DCE) or strongly in favour of virtual consultations (VC - defined as choosing all or mostly VC consultations in the DCE) to elicit a range of views. Interviews were conducted via telephone or videoconference, audio recorded, transcribed verbatim and uploaded into NVIVO software. A directed content analysis of transcripts was undertaken in accordance with a coding framework based on the results of the DCE and the impact of COVID-19 on preference.

Results: eight F2F and 5 VC participants were included. Shorter appointments were less 'worth' travelling in for than a longer appointment and rush hour travel had an effect on whether travelling was acceptable, particularly when patients experienced pain as a result of extended journeys. Socioeconomic factors such as cost of travel, paid time off work, access to equipment and support in its use was important. Physical examinations were preferable in the clinic whereas talking therapies were acceptable over VC. Several participants commented on how VC interferes with the patient-clinician relationship. VC during COVID-19 has provided patients with the opportunity to access their care virtually without the need for travel. For some, this was extremely positive.

Conclusions: this study investigated the results of a previously completed DCE and the impact of COVID-19 on patient preferences for VC. Theoretically informative insights were gained to explain the results of the DCE. The use of VC during the COVID-19 pandemic provided opportunities to access care without the need for face-to-face social interactions. Many felt that VC would become more commonplace after the pandemic, whereas others were keen to return to F2F consultations as much as possible. This qualitative study provides additional context to the results of a previously completed DCE.

Gilbert, Anthony W.
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May, Carl R.
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Brown, Hazel
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Stokes, Maria
71730503-70ce-4e67-b7ea-a3e54579717f
Jones, Jeremy
270b303b-6bad-4be7-8ea0-63d0e8015c91
Gilbert, Anthony W.
a450c811-c6d3-4853-ae35-9f5287db8efa
May, Carl R.
c805896d-01be-420a-b831-5d29f336d7f3
Brown, Hazel
7193d04f-272b-4507-af14-fd4d4eaec34f
Stokes, Maria
71730503-70ce-4e67-b7ea-a3e54579717f
Jones, Jeremy
270b303b-6bad-4be7-8ea0-63d0e8015c91

Gilbert, Anthony W., May, Carl R., Brown, Hazel, Stokes, Maria and Jones, Jeremy (2021) A qualitative investigation into the results of a discrete choice experiment and the impact of COVID-19 on patient preferences for virtual consultations. Archives of Physiotherapy, 11 (1). (doi:10.1186/s40945-021-00115-0).

Record type: Article

Abstract

Objectives: to conduct a qualitative investigation on a subset of participants from a previously completed Discrete Choice Experiment (DCE) to understand why factors identified from the DCE are important, how they influenced preference for virtual consultations (VC) and how COVID-19 has influenced preference for VC.

Methods: a  quota sample was recruited from participants who participated in our DCE. We specifically targeted participants who were strongly in favour of face-to-face consultations (F2F - defined as choosing all or mostly F2F in the DCE) or strongly in favour of virtual consultations (VC - defined as choosing all or mostly VC consultations in the DCE) to elicit a range of views. Interviews were conducted via telephone or videoconference, audio recorded, transcribed verbatim and uploaded into NVIVO software. A directed content analysis of transcripts was undertaken in accordance with a coding framework based on the results of the DCE and the impact of COVID-19 on preference.

Results: eight F2F and 5 VC participants were included. Shorter appointments were less 'worth' travelling in for than a longer appointment and rush hour travel had an effect on whether travelling was acceptable, particularly when patients experienced pain as a result of extended journeys. Socioeconomic factors such as cost of travel, paid time off work, access to equipment and support in its use was important. Physical examinations were preferable in the clinic whereas talking therapies were acceptable over VC. Several participants commented on how VC interferes with the patient-clinician relationship. VC during COVID-19 has provided patients with the opportunity to access their care virtually without the need for travel. For some, this was extremely positive.

Conclusions: this study investigated the results of a previously completed DCE and the impact of COVID-19 on patient preferences for VC. Theoretically informative insights were gained to explain the results of the DCE. The use of VC during the COVID-19 pandemic provided opportunities to access care without the need for face-to-face social interactions. Many felt that VC would become more commonplace after the pandemic, whereas others were keen to return to F2F consultations as much as possible. This qualitative study provides additional context to the results of a previously completed DCE.

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More information

Accepted/In Press date: 21 August 2021
Published date: 6 September 2021
Additional Information: Anthony Gilbert, Clinical Doctoral Research Fellow (ICA-CDRF-2017-03-025) is funded by Health Education England and the National Institute for Health Research (NIHR). Anthony Gilbert and Carl May are supported by the National Institute for Health Research ARC North Thames. The views expressed in this publication are those of the author(s) and not necessarily those of the National Institute for Health Research or the Department of Health and Social Care.

Identifiers

Local EPrints ID: 451521
URI: http://eprints.soton.ac.uk/id/eprint/451521
PURE UUID: 22ec1297-d951-42de-809a-46cdd6b4d6e2
ORCID for Maria Stokes: ORCID iD orcid.org/0000-0002-4204-0890

Catalogue record

Date deposited: 05 Oct 2021 16:32
Last modified: 24 Nov 2021 02:38

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Contributors

Author: Anthony W. Gilbert
Author: Carl R. May
Author: Hazel Brown
Author: Maria Stokes ORCID iD
Author: Jeremy Jones

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