Video clinics versus standard face-to-face appointments for liver transplant patients in routine hospital outpatient care: study protocol for a pragmatic randomised evaluation of my Video Clinic

Research output: Contribution to journalArticlepeer-review

Authors

Colleges, School and Institutes

External organisations

  • Queen Elizabeth Hospital

Abstract

VirtualVideo clinics, where patients can have a hospital appointment with their clinician from home, are emerging in practice, but their effectiveness is unclear. This study will evaluate whether a virtualvideo clinic implemented at University Hospitals Birmingham (UHB) NHS Foundation Trust improves patient satisfaction compared to standard face-to-face appointments for liver transplant patients.

Methods
Parallel, two-arm, statistician-blinded, randomised evaluation. Clinically stable liver patients 1 to 5 years post-transplant (n=180) will be randomised in equal numbers to virtualvideo clinic appointments (intervention) or standard face-to-face appointments (control). The intervention group will have outpatient appointments from home via secure video link accessed through the UHB patient portal. All patients will complete baseline questionnaires before randomisation and electronic follow-up questionnaires after each subsequent follow-up appointment during the subsequent 12 months. The primary outcome is the difference in scores between groups for three domains of patient satisfaction: ‘convenience of location’, ‘getting through to the office by phone’, and ‘convenience of location’ (modified Visit-Specific Satisfaction Instrument, VSQ-9). Secondary outcomes include quality of life (EQ-5D-5L), costs, clinical contacts and user experience. Statistical analysis will be descriptive and on an intention to treat basis. The primary outcome will be analysed using baseline, 3, 6, 9 and 12 months questionnaires (according to patient follow-up appointment frequency) and comparisons made between study arms. A within-trial cost consequences analysis (CCA) will be undertaken on the economic data. Interviews about the experience of virtualvideo clinics will be undertaken with patients (n=8), carers/family members (n=6) and health professionals (n=14). These will be analysed using thematic analysis.

Discussion
This study will allow an in depth understanding of whether virtualvideo clinics can improve patient satisfaction with their care. In addition, the intervention could save patients time and costs, removing the need to travel long distances for outpatient appointments. VirtualVideo clinics may be applicable to a wide range of other clinical settings and health conditions. The study has been approved by the NHS Health Research Authority (HRA) and a National Research Ethics Committee (Ref: 17/WM/0338) and research governance approval has been obtained from UHB (Ref: RRK6080).

Trial registration
ISRCTN: 14093266 (25/03/2018; retrospectively registered)

Details

Original languageEnglish
JournalTrials
Volume19
Issue number574
Publication statusPublished - 19 Oct 2018

Keywords

  • Video clinic, liver transplant, patient satisfaction, randomised evaluation, economic analysis