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Bio-psycho-social situations suitable for the use of teleconsultation in general practice: a doctor-patient mirror
A Mottais1,2, R Tahir1, L Assuied1
1Département universitaire de médecine générale, Université Sorbonne Paris Nord, 99 Av. Jean Baptiste Clément, Villetaneuse 93430, France.
Context:
Few studies on teleconsultation (TC) have focused on comparing the points of view of general practitioners (GPs) and patients.
Objectives:
To explore bio-psycho-social situations suitable for TC according to GPs and patients.
Methods:
A qualitative study, with thematic analysis, was conducted. Data were collected through individual, semi-directed face-to-face or remote interviews with GPs and patients. The interview guide was validated by a steering committee that included patients. Maximum variation sampling of established GPs and patients was based on diversification criteria.
Results:
Thirteen patients and eleven physicians were included in this study. The main condition for TC was a pre-established relationship of trust. It was used on an Ad hoc basis as an alternative to face-to-face consultations. Patients and GPs identified that the use of TC should be the result of a shared decision. Participants agreed on the situations in which the use of TC could be justified: to respond to one-off, specific requests, for benign reasons or reasons not requiring a physical examination. Patients considered their health experience and level of health literacy to be strong determinants of TC use. Participants noted the risk of TC widening certain inequalities in access to care.
Conclusion:
Patients and doctors have identified the same suitable situations and the need to respect certain prerequisites. TC seems appropriate when its use is the result of a prior shared decision between patient and GP.
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