Patient and clinician satisfaction with video consultations in dentistry - part one: patient satisfaction

Global Evidence on the Sustainability of Telemedicine in Outpatient and Primary Care During the First 2 Years of the COVID-19 Pandemic: Scoping Review Using the Nonadoption, Abandonment, Scale-Up, Spread, and Sustainability (NASSS) Framework

BACKGROUND

The rapid implementation of telemedicine during the early stages of the COVID-19 pandemic raises questions about the sustainability of this intervention at the global level.

OBJECTIVE

This research examines the patient experience, health inequalities, and clinician-patient relationship in telemedicine during the COVID-19 pandemic's first 2 years, aiming to identify sustainability factors.

METHODS

This study was based on a prepublished protocol using the Joanna Briggs Institute (JBI) methodology for scoping reviews. We included academic and gray literature published between March 2020 and March 2022 according to these criteria: (1) population (any group); (2) concepts (patient experience, clinician-patient relationship, health inequalities); (3) context (telemedicine in primary and outpatient care); (4) excluding studies pertaining to surgery, oncology, and (inpatient) psychiatry. We searched Ovid Medline/PubMed (January 1, 2022), Web of Science (March 19, 2022), Google/Google Scholar (February and March 2022), and others. The risk of bias was not assessed as per guidance. We used an analysis table for the studies and color-coded tabular mapping against a health care technology adoption framework to identify sustainability (using double-blind extraction).

RESULTS

Of the 134 studies that met our criteria, 49.3% (66/134) reported no specific population group. Regarding the concepts, 41.8% (56/134) combined 2 of the concepts studied. The context analysis identified that 56.0% (75/134) of the studies referred to, according to the definition in the United Kingdom, an outpatient (ambulatory care) setting, and 34.3% (46/134) referred to primary care. The patient experience analysis reflected positive satisfaction and sustained access during lockdowns. The clinician-patient relationship impacts were nuanced, affecting interaction and encounter quality. When mapping to the nonadoption, abandonment, scale-up, spread, and sustainability (NASSS) framework, 81.3% (109/134) of the studies referenced the innovation's sustainability. Although positive overall, there were some concerns about sustainability based on quality, eHealth literacy, and access to health care for vulnerable migrants and the uninsured.

CONCLUSIONS

We identified confusion between the concepts of patient experience and patient satisfaction; therefore, future research could focus on established frameworks to qualify the patient experience across the whole pathway and not just the remote encounter. As expected, our research found mainly descriptive analyses, so there is a need for more robust evidence methods identifying impacts of changes in treatment pathways. This study illustrates modern methods to decolonize academic research by using gray literature extracts in other languages. We acknowledge that the use of Google to identify gray literature at the global level and in other languages has implications on reproducibility. We did not consider synchronous text-based communication.

TRIAL REGISTRATION

Open Science Framework 4z5ut; https://osf.io/4z5ut/.

Acceptability of teledentistry use among residents and staff in aged residential care facilities in the Otago region of New Zealand

OBJECTIVES

To assess ARC residents' and staff perceptions of the benefits of, and comfort with, teledentistry use in ARC facilities in the Otago region of NZ, and identify end-user-level factors associated with its use.

BACKGROUND

Difficulty in accessing oral healthcare services is a key barrier to aged residential care (ARC) residents' oral health and well-being. Teledentistry offers a possible solution, yet studies on its acceptability in ARCs are sparse, especially in New Zealand (NZ). This study assessed ARC residents' and staff perceptions of the benefits of, and comfort with, teledentistry use in ARC facilities in the Otago region of NZ and identified end-user-level factors associated with its use.

MATERIALS AND METHODS

Rest home-level residents and care staff in ARC facilities in the Otago region of NZ were surveyed to assess their awareness of teledentistry, perceptions of benefit and comfort using teledentistry, and end-user-level factors associated with the feasibility of using it in ARCs.

RESULTS

One hundred residents and 77 care staff from 14 facilities participated. Three-quarters of resident participants thought that teledentistry was beneficial. Three in five resident participants were comfortable receiving remote dental consultations and care advice through teledentistry. Acceptability, as measured by perceived benefits and comfort, was lower among older participants. Staff participants were receptive to teledentistry use for residents and were comfortable facilitating remote dental consultations and care through teledentistry. No staff participants disagreed with the potential benefits of teledentistry for ARC residents.

CONCLUSION

Teledentistry would likely be acceptable to residents and staff in ARC facilities in NZ, contributing to residents' improved access to oral health care and improved oral health and well-being.

Patient's and Practionner's Experiences of a First Face-to-Face vs. Remote Orthodontic Consultation: A Randomized Controlled Trial

(1) Aim: The purpose of this study was to assess patients' and practitioners' reported experience measures (PREMs) following a first standard orthodontic consultation (face-to-face consultation) versus a first orthodontic teleconsultation (video-assisted remote orthodontic consultation).; (2) Materials and Methods: This study was designed as a randomized controlled trial in which 60 patients were randomly allocated to two groups. In the control group, patients received a first face-to-face consultation (n = 30) whereas, in the test group, patients received a first orthodontic teleconsultation (n = 30). Patients as well as the orthodontic practitioners completed questionnaires after the experience. (3) Results: From the patients' point of view, overall satisfaction was comparable between the control group and the test group (p = 0.23). Quality of communication with the clinician, understanding of the explanations provided and a sense of privacy were also comparable between the two groups. However, from the practitioners' perspective, overall satisfaction after the face-to-face consultation was significantly higher than after the first remote consultation (p < 0.01). (4) Conclusions: In the context of a first orthodontic consultation, teleorthodontics appears to be an interesting and complementary approach to a classical face-to-face appointment, but which should by no means become systematic.

Adoption of video consultations during the COVID-19 pandemic

BACKGROUND

Video consultations have the potential to play a significant role for the future of healthcare by solving some of the imminently arising healthcare challenges, as pointed by the European Commission in Europe and the National Academy of Medicine in the United States of America. This technology can improve quality, efficiency, and enhance access to healthcare.

OBJECTIVE

The aim of this study is to explore and understand individual video consultations acceptance drivers.

METHODS

An extended technology acceptance model was created based on the diffusion of innovation theory (DOI), unified theory of acceptance and use of technology (UTAUT), health belief model (HBM), and concerns for information privacy framework (CFIP). 346 valid responses were collected through an online questionnaire, and the partial least squares (PLS) modeling approach was used to test the model.

RESULTS

The model explained 77.6 % (R2) of the variance on intention to use, and 71.4 % (R2) of the variance in attitude. The predictors of intention to use are attitude (beta = 0.504, p-value<0.001), performance expectancy (beta = 0.196, p-value = 0.002), and COVID-19 (beta = 0.151, p-value<0.001). The predictors of attitude are performance expectancy (beta = 0.643, p-value>0.001), effort expectancy (beta = 0.138, p-value = 0.001), and COVID-19 (beta = 0.170, p-value<0.001).

CONCLUSIONS

This research model highlights the importance of creating extended acceptance models to capture the specificities of each technology in healthcare. The model created helps to understand the most important drivers of video consultation acceptance, highlighting the importance of the COVID-19 pandemic and perceived health risks.

A survey regarding orthodontic treatment among contemporary college freshmen in China

Background

A growing number of Chinese residents are seeking orthodontic treatment. The aim of the study was to investigate rates of orthodontic publicity, orthodontic treatment history and related factors among college freshmen in China, to preliminarily understand the current situation of orthodontic publicity and treatment in China, especially after the 2020s.

Methods

Referred to previous studies, a self-designed online questionnaire of Chinese college freshmen was conducted. The questionnaire was divided into two parts, after collecting basic information, we investigated orthodontic publicity rate and orthodontic treatment history with starting age, relapse phenomenon, satisfaction score and willingness to re-treatment. Factors hindering first-time and second-time treatment were also collected. The statistical analysis was performed using the Chi-square test, t-test, Kruskal–Wallis test and logistic regression analysis.

Results

The response rate was 100% and 3308 responses were included. The male to female ratio was 1524:1784 with a mean age of 18.43 years (SD 0.91 years). Statistically significant of economic administrative regions, age, major and orthodontics engagement of relatives or friends were found on prevalence and rate of orthodontic treatment (P < 0.05). Average opinion on orthodontic treatment was “satisfied” and most claimed a phenomenon of relapse (slight relapse: 38.22%, obvious relapse: 23.12%), where age, major and orthodontics engagement of relatives or friends showed statistically significant. Retreatment willingness was correlation with start age and relapse phenomenon. For those who refused first-time treatment, except for good tooth arrangement condition, pain, long-time span, and cost weighted, while for those who refused re-treatment, the fair of discomfort and long-time span ranked at the top.

Conclusions

In contemporary China, the prevalence and rate of orthodontic treatment had been greatly promoted. Earlier age for receiving orthodontic treatment was also discovered. Subjective factors regarding psychology, self-requirement affected the need of orthodontic treatment. Contemporary Chinese college freshmen had a high ability of judging dental alignment, while improve of overall orthodontic care level is still required.

Virtual consultations for oral surgery patients

BACKGROUND

Following Covid-19, many departments have incorporated teledentistry into practice. As new consultation methods are introduced, it's imperative that patients have as similar an experience with virtual consultations to ensure informed decision-making. This project evaluated patients' perceptions of video consultations and determined if patients seen virtually received the same standard of information by auditing compliance with sending patient information leaflets (PILs) following video consultation.

METHOD

The department's PILs were used to create an inclusion list for patients requiring a PIL. A retrospective audit assessed the notes of 100 video consultations for records of if PILs were sent and by what method. The department's PILs were digitalised and a clinical mailbox introduced enabling clinicians to email patients a PIL hyperlink. The audit was repeated for 88 video consultations. Patient and staff feedback was gathered via online surveys.

RESULTS

Initially, 51% of cases met the criteria requiring a PIL and 16% of patients were sent PILs. Following mailbox introduction, 53% of cases met the criteria and 94% were sent PILs, 100% via email. Patient and staff feedback was positive regarding video consultations and digital PILS. Technical difficulties were reported in 44% of cases.

CONCLUSIONS

Patients perceive virtual consultations to be a positive change and the introduction of a mailbox enhances video consultations in an efficient and cost-effective manner. Patient information can be standardised, via digital PILs, regardless of consultation type. As departments implement post-pandemic changes, utilisation of a mailbox can provide multiple improvements to care.

Remote clinical consultations in restorative dentistry-A survey

OBJECTIVES

To assess the patient experience of Remote Clinical Consultations (RCCs) for head and neck cancer and cleft lip and palate patients undergoing specialist restorative dentistry treatment in the context of a secondary care service.

METHODS

An online survey was designed; all ninety three patients were invited to participate in its completion following a video or telephone remote clinical consultation with one restorative consultant in Addenbrooke's Hospital between August 2020 and April 2021. The video consultations were carried out via NHS England's Attend Anywhere platform.

RESULTS

Sixty three responses were received. Over 70% of patients valued a video or telephone remote clinical consultation rather than an in-person attendance. Patients reported a good experience and would recommend a remote clinical consultation instead of an in-person attendance if no treatment would likely be required. Those who were less likely to recommend a remote clinical consultation were those who had difficulties logging-in to the remote platform or had technical issues.

CONCLUSION

While a number of patients still would have preferred a face-to-face attendance, both telephone and video remote consultations were highly valued by patients, and the overall patient experience was that of acceptance. Benefits of remote consultations perceived by patients included having set time to discuss concerns and queries, becoming familiar with a clinician prior to any treatment, saving time, minimising travel and reducing expenses. Barriers to a positive experience included technical difficulties. This survey contributes to the evidence supporting remote clinical consultations as a practical way of delivering specialist consultations in restorative dentistry, it highlights this virtual process largely relates to the practicalities of service provision and highlights the use of remote consultations for specific appointments.

CLINICAL SIGNIFICANCE

This study demonstrates patient feedback to a strategy implemented due to adaptations in working methods required as result of the Covid-19 pandemic. Patients were found to have a positive, accepting experience of both telephone and video remote clinical consultations. the study identifies a high patient acceptability and ability to overcome some of the disadvantages of an in-person attendance including saving time, travel and associated expenses while also contributing to a reduction in CO₂ emissions and potentially improving clinical efficiency and capacity. These findings add to existing evidence and are indicative that remote consultations provide a practical way of delivering specialist communication in restorative dentistry as part of a unique patient pathway.