DRWF Research: Supporters express their thoughts on virtual consultations with healthcare professionals

What do people living with diabetes think about remote consultations? The results of a survey supported by DRWF aimed to find out – and the results have now been published.

DRWF supporters who attended a virtual diabetes educational event last year, and readers of the DRWF monthly newsletter, Diabetes Wellness News, were asked to provide their feedback on preferred methods of interacting with their diabetes healthcare professionals for appointments.

The widespread survey was carried out by Consultant Physicians at the Northampton General Hospital NHS Trust Diabetes Centre Dr Charles Fox (retired) and Anne Kilvert and supported by DRWF Event Co-ordinator Lee Calladine on behalf of the charity.

In November 2020, DRWF hosted the United Through Diabetes virtual conference for people with diabetes in partnership with Diabetes Professional Care. Those attending a presentation on How to get the best out of your virtual consultation answered an online questionnaire about their experiences of remote consultation.

Fifteen of the 24 responders had type 1 diabetes; two had type 2 diabetes; one was a carer and six were healthcare professionals. Seven people had experienced video consultations and 13 had phone calls only. Sixty per cent were very or fairly satisfied with these consultations, while 22.7% were somewhat dissatisfied. The preference for future consultations (face to face or remote) was split 50:50.

In addition, a questionnaire was distributed to readers of DRWF’s monthly newsletter - Diabetes Wellness News in December 2020, asking about experience of virtual consultations.

Respondents were asked eight questions about access to technology, experience of virtual consultations (defined as video or phone), whether they had the opportunity to discuss worries they had about their diabetes and what their preference would be for mode of consultation once the pandemic is over.

A total of 312 responses were received from a circulation of 9,328 (3.4%). After excluding those outside the four specified categories (type 1 diabetes; type 2 diabetes; carer or relative; healthcare professional working in diabetes), 301 responses remained: 277 from people with diabetes or their carers and 24 from healthcare professionals (analysed separately).

During the pandemic a total of 46 people (17%) had experienced a face-to-face consultation, 92 (33%) had a virtual (phone or video) consultation and 13 (4.7%) had both face to face and virtual. A further 97 (35%) stated that they had not needed a consultation and 23 (8.3%) would have liked a consultation but had not been offered one.

Although 100 people (36%) had access to video technology, only 20 had a video consultation, representing only 7.2% of the total number with diabetes in the survey. People with type 1 diabetes were more likely to have access to video technology than those with type 2 (47% vs 34%) and those with video technology were more likely to have video consultations if they had type 1 (24.4%) than type 2 (3.8%).

Study authors said: “The paper-based survey enabled those without access to technology to express their views, suggesting that this matters to people. There was an overwhelming preference, from people with diabetes and from healthcare professionals, to return to face-to-face appointments when possible.

“Although more than a third of respondents had access to video technology, this was rarely used for consultations, which were mostly conducted by phone, suggesting that use of video technology is not widespread.

“More people with type 1 diabetes had experienced video consultations (possibly because they were followed up in secondary care), but this only represented 24% of the study. Less than 4% of people with type 2 diabetes had been offered video consultations, which may reflect a greater dependence on the phone in primary care.

“One-third of respondents were dissatisfied with their remote consultation. People with diabetes and healthcare professionals were equally concerned about difficulties engaging and talking freely during a remote consultation; but there were also comments that lack of visibility sometimes made communication easier. Only 12.5% of respondents had been able to discuss particular diabetes concerns fully and although we know little about this aspect in face-to-face consultation, it does highlight a need to ensure that emotions such as diabetes distress are addressed in the remote situation.”

Report authors concluded: “Without doubt, remote consultations will form a large part of diabetes care in the future. These online and paper surveys demonstrate that many people with access to technology find virtual consultations very acceptable, but there are concerns about confidentiality, safeguarding and ability to communicate or identify emotional distress.

“The DRWF paper survey provides important information about preferences, irrespective of access to technology. This may partly reflect differences between primary and secondary care, but personal preference was influenced by a wide range of factors, including: time and travel; confidentiality and safeguarding; ability to be open and honest in either the virtual or face-to-face setting. There is no ‘one size fits all’ and individual preferences are not dependent on specific categories, such as type of diabetes or even access to technology.

“More work needs to be done to ensure that remote clinics meet the needs of the whole diabetes population, in particular the provision of a ‘safe space’ for all users.”

Read the report in Practical Diabetes

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