Some remote GP appointments as effective as face-to-face ones

Source: Practice Index  4.9.23

Remote GP and other primary care consultations can be as effective as face-to-face appointments for some conditions, new research has found.

A study by a team at Imperial College London said health outcomes for patients who had remote appointments for mental illness, alcohol misuse, weight management and for advice on stopping smoking at least matched those for in-person care. The findings, published in the Journal of Medical Internet Research, were based on a review of previous research involving more than 5.4 million patients in countries across the world.

Lead study author Dr Ana Luisa Neves, from the School of Public Health at Imperial College London, said: “COVID-19 caused a huge and rapid expansion in the use of virtual consultations in primary care. As part of an emergency response, it wasn’t possible to properly consider the impacts at the time. Now, it is really important that we better understand what this immense change means, especially for patient outcomes, safety and equity. Based on the evidence we analysed, it seems that remote care is equally beneficial on health outcomes for certain conditions including mental health, alcohol misuse and smoking cessation. For these conditions, evidence shows patients can get the same effectiveness of care as they would in face-to-face appointments.”

The Imperial researchers identified 30 studies that compared video- or phone-based primary care consultations with those carried out face-to-face published between 2017 and 2022. Most were in the USA, with others in the UK, Canada, Sweden, New Zealand, Singapore, UK, Japan and Kenya. Some of the studies covered general primary care such as GP appointments while others focused on specific conditions or groups of conditions. The studies were reviewed as to whether virtual care was superior, equal to or inferior to face-to-face care on costs, health outcomes, safety, patient satisfaction, waiting times and equity.

Remote consultations reduced financial costs and saved time for doctors in some cases and the studies that compared health outcomes found remote appointments to be as effective as in-person ones for the areas the studies looked at, which were mental health problems including depression and anxiety; reducing alcohol consumption; stopping smoking; and weight management. One study found virtual care to be superior for treating ulcers.

There was some evidence that remote consultations were more convenient, but also that patients seen virtually felt less well supported in making informed choices autonomously. There was insufficient evidence to enable the researchers to assess the impact of virtual consultations on patient safety, and the researchers say there is a need to further explore their impact on equity.

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