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Dear Editor, dermatologists have relied heavily on telephone consultations (TC) following the first UK national lockdown. Current UK literature comparing patient perceptions of TC to face-to-face consultations (F2FC) indicates a F2FC preference, although this research includes patients who have not experienced both F2FC and TC [3].
Between the 6th December 2021 and 16th December 2021, to assess the role of TC in secondary-care dermatology during the UK COVID-19 era, we retrospectively surveyed, via telephone, adult secondary-care dermatology patients from a single centre (London, UK) who attended one or more TC from January to February 2021 and one or more F2FC within one year before the first UK national lockdown for the same condition(s) (n = 157). We asked eleven questions (questions (Q)1-Q11), adapted from previous literature [1, 3]. Demographic data was acquired using patient records and Q1-Q6 (Table 1). Q7-Q11 (Fig. 1) determined patient satisfaction, consultation preference, and preference reasoning.
Seventy-four patients participated (Table 1, 47.13% response rate). Most patients were excluded because they did not answer the telephone (n = 34). The final cohort consisted of 43 women and 31 men with a median age of 52 years (interquartile range (IQR) = 27.25). Overall, patient satisfaction with the quality of care was significantly higher in F2FC than during TC (p < 0.001) (Fig. 1a), with most patients describing F2FC as “very good” (n = 42,56.76%) and TC as “good” (n = 28, 37.84%). While the majority of patients (47.30%, n = 35) thought that TC led to the same level of care as F2FC (Fig. 1b), 41.89% (n = 31) claimed that TC care was worse. Most patients (81.08%, n = 60) preferred F2FC (Fig. 1c). Of the 117 reasons (Fig. 1d) explaining this preference, “able to show skin” (n = 47) was the most common. Lack of travel (n = 3) was the most popular reason (n = 9) for preferring TC.
Our cohort’s favouritism towards F2FC likely stems from its unique advantages, including non-verbal communication. Moreover, patients may desire the normalcy of F2FC, considering we collected data following the ease of COVID restrictions and the re-introduction of in-person opportunities (March 2021). Our results support the findings of Handa et al. [4], and Edward et al. [2], who also reported patients having an unfavourable view of TC compared to F2FC, but contrast to those documented by Gnanappiragasam et al. [3], who found no consultation preference. Most patients we hoped to recruit failed to answer the telephone, with those participating recalling almost a year back to their TC. Additionally, several patients hesitated to critique TC despite their anonymized responses. Since a degree of sample selection bias, recall bias, and social desirability bias is likely to present, future research should endeavour to collect prospective data using initial indirect surveying. Despite the F2FC preference, it is encouraging that our patients believe TC are “good”. Nevertheless, TC are an essential tool for triage and remote care, so there is a need to maximize satisfaction. Such changes are crucial for minimizing non-engagement with remote services and developing long-term care delivery strategies that adapt to COVID-19’s continuing presence, a challenge given the importance of visual inspection in dermatology [5].
Data availability
The datasets generated during and/or analysed during the current study are available from the corresponding author on reasonable request.
References
Ball SL, Newbould J, Corbett J et al (2018) Qualitative study of patient views on a “telephone-first” approach in general practice in England: speaking to the GP by telephone before making face-to-face appointments. BMJ Open 8(12):e026197. https://doi.org/10.1136/bmjopen-2018-026197
Edwards HA, Shen X, Soyer HP (2021) Teledermatology adaptations in the COVID-19 era. Front Med (Lausanne) 8:675383. https://doi.org/10.3389/fmed.2021.675383
Gnanappiragasam D, Oldham J, Panchal M, Woo WA (2021) Experience and perception of face-to-face vs. remote consultations: a patient survey across two UK dermatology centres. Clin Exp Dermatol 46(4):736–737. https://doi.org/10.1111/ced.14528
Handa S, Mehta H, Bishnoi A et al (2021) Teledermatology during the COVID-19 pandemic: experience at a tertiary care centre in North India. Dermatol Ther 34(4):15022. https://doi.org/10.1111/dth.15022
Wang RH, Barbieri JS, Kovarik CL, Lipoff JB (2022) Synchronous and asynchronous teledermatology: a narrative review of strengths and limitations. J Telemed Telecare 28(7):533–538. https://doi.org/10.1177/1357633X221074504
Acknowledgements
Serena Ramjee: conceptualization; formal analysis; investigation; methodology; project administration; visualization; writing—original draft; writing—review & editing. Louis Boyce: formal analysis; visualization; writing—original draft; writing—review & editing. Padma Mohandas: conceptualization; resources; supervision; writing—review & editing. Dr Bjorn Thomas proposed and initiated this study.
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This research did not receive any specific grant from funding agencies in the public, commercial, or not-for-profit sectors.
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S.R: Conceptualization; Formal analysis; Investigation; Methodology; Project administration; Visualization; Writing - original draft; Writing - review & editing. L.B: Formal analysis; Visualization; Writing - original draft; Writing - review & editing. P.M: Conceptualization; Resources; Supervision; Writing - review & editing.
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This quality improvement project was registered with the local Clinical Effectiveness Unit via the Life QI system. No ethical approval was required.
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Ramjee, S., Boyce, L. & Mohandas, P. Telephone consultations in the COVID-19 era versus pre-COVID face-to-face consultations: a survey of dermatology patient perceptions. Arch Dermatol Res 315, 1843–1846 (2023). https://doi.org/10.1007/s00403-023-02561-1
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DOI: https://doi.org/10.1007/s00403-023-02561-1