Patients' and providers' experiences with video consultations used in the treatment of older patients with unipolar depression: a systematic review

The aim of this study was to investigate the experiences of patients and providers regarding the use of videoconferences in older patients with depression. The qualitative study consisted of semi‐structured interviews with patients and providers and focus group interviews with providers. Themes were identified through using thematic analysis. Three main themes were as follows: 1. Technical Challenges experienced by patients and providers experiences; 2. Videoconferencing as clinical supportive technology; and 3. Therapeutic relationship across face‐to‐face and videoconferencing formats. Several subthemes describing patients’ and providers’ experiences were identified. Taken together, there was a similarity between expectations, opinions, and attitudes in relation to experiences vertically across all main themes, and horizontally between the main themes. An optimistic outlook influenced user expectations, opinions, and attitudes and acted to mitigate an negative sentiment about technical challenges. This increased the adoption of videoconferencing as a tool for clinical support and enabled the development of a therapeutic relationship using videoconferencing, especially for provider users. Both patients and providers agreed that videoconferences could not replace all face‐to‐face conversations and that videoconferences, in most cases, were best suited for shorter follow‐up consultations. Expectations, opinions, and attitudes, whether negative or positive, seemed to have significant impact on the experiences of patients and especially providers.

Background Clinical effectiveness of video consultations in the mental health services is comparable with in-person consultations. Acceptance has typically been rated in surveys that do not give a deeper understanding behind the phenomenon. The aim of this synthesis is to explore mental health patients’ perceptions of factors that influence their acceptance of video consultations viewed from the perspective of the patient. Methods A literature search in scientific databases was conducted. Peer-reviewed reports of qualitative research exploring patients’ experiences with video consultations from the patients’ perspectives were included. Then a meta-summary and a taxonomic analysis were conducted. Results A total of 11 reports met the inclusion criteria. Through the analysis, a model was generated with five factors that precede each other and interact with each other. Patients thought video consultations were acceptable when (1) they experienced barriers and inconvenience to accessing the location of services, (2) they had already established a trustful relationship with their therapist, (3) technical interferences were minor and problems were resolved quickly, (4) patients expected a less personal meeting, and (5) the degree of the patients’ issues were less complex. Discussion This model is intended to help clinicians identify circumstances where offering video consultations make best sense to patients and help sustain meaningful use prospectively. When patients encounter barriers to in-person services, clinicians should consider offering video consultations when the technology is adequately integrated in practice, and it is perceived not to intervene with treatment or the therapeutic process.