Experiences of Outpatient Clinics and Opinions of Telehealth by Caucasian and South Asian Patients’ With Celiac Disease

Abstract

Outpatient clinics are an important part of chronic disease management, including that of celiac disease. During the coronavirus disease 2019 (COVID-19) global pandemic, telephone and online video consultations with health care professionals have substantially increased. This study aimed to explore the experience and opinions of adults, with celiac disease, toward face-to-face clinic appointments and alternatives, such as telehealth. Semistructured qualitative interviews with 37 patients were undertaken (75% White Caucasians, 25% South Asians; 29 patients were not adhering to the gluten-free diet). Interviews were recorded, transcribed, and analyzed by NVivo. Frequently reported issues with face-to-face appointments included travel and car parking costs, needing to take time off work, and frequent changes to appointment time. In addition, South Asian patients highlighted issues with linguistics barriers. Telephone consultations were considered acceptable and practical by the majority of patients based on ease and convenience. Online video consultations were favored by just 9 patients, however it is acknowledged that since the COVID-19 pandemic, there has been a greater exposure to this type of technology. These patient experiences can inform health care service development and are not biased by external health concerns connected with in-person visits during the pandemic.

Patient Experience from an eHealth Perspective: A Scoping Review of Approaches and Recent Trends

“…Satisfaction studies report the use of patient satisfaction questionnaires resulting in patient satisfaction scores [18,21,22,25] whereas "patient engagement" refers to the amount of engagement with eHealth solutions [30] or online patient engagement practices [31]. PX is also equated with the experiences of patients [20,[32][33][34][35][36], which is described as related to technology (e.g., "virtual experience for patients with COVID-19 symptoms" [33] and "telemedicine experiences of individuals" [34]). "Patient perception" refers to the "perception of the interaction related to use of a telemedicine service" [22] or to "patient perceptions of the virtual rounding experience" [32].…”

“…These studies point out the following quality aspects of remote care: patient burden [55], access to information [55], the amount of information given to the patient by the provider [56], the experience of being heard [56,57], trust towards the provider concerning care [56], the ease of contacting the clinic and scheduling the appointment [35,56,57], the experience of safety protection [35,57,58], and the decrease in nonverbal communication [36].…”

“…Generally, virtual visits and consultations are considered acceptable and practical compared to in-person appointments [35,52]; however, older patients prefer face-to-face appointments or access to video consultation facilities [24].…”

“…(incl. qualitative and/or quantitative questions) [19,20,[22][23][24][25]28,29,34,40,43,46,[52][53][54][56][57][58]60] Interview [30,32,35,37,42,45,59] Focus group [36,41] Service analysis [31,51] Design methods [44] Reviews [26,39,49] Implementation study [18,21,50,61] Cross-sectional study [27,33] eHealth pilot or trial [38,43,47,48,55] The most frequently used method (i.e., surveys) was applied in 18 papers (see Figure 2). As patient satisfaction was one of the most mentioned aspects affecting PX, patient satisfaction surveys were the most broadly applied.…”

Information Needs of Punjabi Patients with Coeliac Disease

“…The importance of this issue is seen in that South Asians who did not understand food labelling had a significantly poorer dietary adherence than those who did [3]. Clearly, language barriers play a significant role in such difficulties, as demonstrated in a study of telephone clinics [4]. Indeed, a recent systematic review of 40 published studies has shown that significant barriers to compliance include: lower knowledge of coeliac disease (35%); restaurant/ supermarket shopping (30%); poor patient education from practitioner (17.5%); and low intention/motivation to adhere to a GFD (17.5%) [5].…”