Long COVID as a never-ending puzzle: the experience of primary care physicians. A qualitative interview study

Abstract

BackgroundLong COVID provides a new context in which primary healthcare needs to be reexamined, especially because it has health and social dimensions. The experiences of care for patients with long COVID and primary care physicians’ perceptions are an unexplored area.AimTo explore the experiences of Slovenian primary care physicians in management and treatment of patients with long COVID.Design & settingA qualitative interview study in Slovenian primary care was carried out between November 2021 and April 2022.MethodSemi-structured interviews were held with physicians that had treated patients with long COVID until saturation was reached. Qualitative content analysis (QCA) was used to analyze the data collected.ResultsSeventeen participants were interviewed. Six categories were defined based on the coding process: the definition and symptoms of long COVID; social exclusion, sick leave, returning to the work environment, cooperation with rehabilitation centers and the importance of trust and good communication with the patient.ConclusionThe study shows the experiences of Slovenian primary care physicians in the management and treatment of long COVID. The problems related to long COVID were divided into two groups: health problems and psycho-social problems. Slovenian physicians have the greatest problems with dealing with the patient’s ability to work. It was found that adequate communication and trust between physicians and patients are two important indicators for an integrated model of managing long COVID.

Enhancing long COVID care in general practice: A qualitative study

“…Meanwhile, this study’s findings contrast with those of much previous research in the area as they provide a close focus on the perspectives of general practice stakeholders. And while the findings of studies conducted by Jamoulle et al [ 10 ], Rotar Pavlic et al [ 34 ], and Taylor et al [ 35 ] also focused on long COVID in general practice, we believe this study is the first to examine both stakeholder groups simultaneously using a comparative analysis technique. By using the constant comparison method, we were able to highlight previously unpublished points of agreement between GPs and patients regarding long COVID care, as well as differences between the priorities that both groups held.…”

“…Of the eight qualitative studies found relating to long COVID in general practice and primary care, two simultaneously examined the perspectives of primary care practitioners (not GPs) and patients [ 28 , 33 ]. Other studies examined the views of GPs [ 34 ], general practice patients [ 10 ], patients recruited from the community rather than from primary care or general practice [ 30 ], patients referred to a primary care integrated psychology service [ 24 ], doctors from social media (of which eight were GPs) [ 35 ], and members of the general public recruited via social media [ 20 ]. The largest study sample containing both general practice / primary care practitioner and patient participants involved 198 paricipants (patient n = 126; primary care practitioner n = 72) and employed content analysis of open-ended survey responses rather than in-depth interviews [ 28 ].…”

“…The other study containing clinician and patient participants recruited a sample size of 52 which included 40 patients and 12 healthcare providers, albeit only two of these providers were GPs [ 33 ]. Four studies were conducted in the UK [ 20 , 24 , 33 , 35 ], while single studies were conducted in Germany [ 28 ], Belgium [ 10 ], Slovenia [ 34 ], and the USA [ 30 ]. In sum, the long COVID qualitative research field has made progress.…”

“…The findings of the qualitative studies conducted to date regularly point to the importance of ‘long COVID aware’ clinicians and stress the worth of providers that (1) inform person centred care and recovery by listening closely to patients with long COVID [ 20 , 30 , 33 , 35 ], (2) overcome psychological difficulties caused by uncertainty regarding long COVID’s often unpredictable symptom progression, treatment course, and functional impacts [ 20 , 24 , 28 , 34 , 35 ], and (3) facilitate high standards of longitudinal, multidisciplinary, and integrated patient care [ 10 , 20 , 28 , 30 , 33 , 35 ]. Thus, the solutions proposed by these qualitative studies are largely like those reported in the wider research around primary care management of long COVID.…”

“There is no one who helps you with it”: experiences of people with long COVID regarding medical care, therapeutic measures, and barriers in the German healthcare system: results of a qualitative study with four focus groups

“…In an interview study, GPs also reported major challenges in treating patients with long COVID. In particular, the diagnosis of long COVID, the handling of psychosocial problems and the ability to work of affected patients, and the prescription of rehabilitation measures caused great difficulties for GPs due to the lack of uniform guidelines [ 49 ].…”