RT Journal Article
SR Electronic
T1 Inequalities in general practice remote consultations: a systematic review
JF BJGP Open
JO BJGP Open
FD Royal College of General Practitioners
SP BJGPO.2021.0040
DO 10.3399/BJGPO.2021.0040
VO 5
IS 3
A1 Parker, Ruth F
A1 Figures, Emma L
A1 Paddison, Charlotte AM
A1 Matheson, James IDM
A1 Blane, David N
A1 Ford, John A
YR 2021
UL http://bjgpopen.org/content/5/3/BJGPO.2021.0040.abstract
AB Background COVID-19 has led to rapid and widespread use of remote consultations in general practice, but the health inequalities impact remains unknown.Aim To explore the impact of remote consultations in general practice, compared to face-to-face consultations, on utilisation and clinical outcomes across socioeconomic and disadvantaged groups.Design & setting Systematic review.Method The authors undertook an electronic search of MEDLINE, EMBASE, and Web of Science from inception to June 2020. The study included studies that compared remote consultations to face-to-face consultations in primary care and reported outcomes by PROGRESS Plus criteria. Risk of bias was assessed using ROBINS-I. Data were synthesised narratively.Results Based on 13 studies that explored telephone and internet-based consultations, this review found that telephone consultations were used by younger people of working age, the very old, and non-immigrants, with internet-based consultations more likely to be used by younger people. Women consistently used more remote forms of consulting than men. Socioeconomic and ethnicity findings were mixed, with weak evidence that patients from more affluent areas were more likely to use internet-based communication. Remote consultations appeared to help patients with opioid dependence remain engaged with primary care. No studies reported on the impact on quality of care or clinical outcomes.Conclusion Remote consultations in general practice are likely to be used more by younger, working people, non-immigrants, older patients, and women, with internet-based consultations more by younger, affluent, and educated groups. Widespread use of remote consultations should be treated with caution until the inequalities impact on clinical outcomes and quality of care is known.