Patient Preferences for In-Person vs Remote Care for Long-Term Conditions

Importance As health care systems face greater strain due to the increasing prevalence of long-term conditions (LTCs) and workforce shortages, optimizing remote care could help maintain access to timely follow-up care while alleviating pressure on in-person services. Objectives To assess the availability and use of 3 remote modalities by patients with LTCs for interacting with their referring physician; their preference for in-person vs remote consultation for different situations; and their willingness to trade an in-person consultation with their referring physician in 20 days for an earlier remote consultation with a nonreferring physician. Design, Setting, and Participants This survey study was conducted from April 1 to August 28, 2024, in France. Adult patients with at least 1 LTC participating in a nationwide e-cohort were recruited to complete an online survey. To obtain estimates representative of patients with LTCs in France, analyses were performed on a weighted dataset with calibration on margins from the 2021 Santé Publique France Survey. Exposures Each patient was presented with 1 of 5 randomly assigned situations regarding worsening symptoms, new symptoms, annual checkup, medication renewal, and results discussion. Main Outcomes and Measures Responses were assessed for (1) availability and use of remote modalities (video consultation, telephone contact, and asynchronous message exchange) for interacting with the referring physician; (2) patient preference for in-person or remote modalities when interacting with the referring physician depending on the situation; and (3) patient willingness to trade an in-person consultation with their physician in 20 days for an earlier direct-to-consumer (DTC) remote consultation with a nonreferring physician. Results Among 1995 participants (mean SD age, 55 17 years; 56% women), 47% reported that no remote modalities for communicating with their referring physician were available. (All percentages presented are weighted.) Up to 55% preferred remote over in-person consultation to interact with their referring physician, with higher proportions for results discussion (43%) and medication renewal (55%) than for worsening symptoms (36%), new symptoms (25%), and annual checkup (26%). Up to 51% of patients were willing to trade an in-person consultation with their referring physician in 20 days for a DTC remote consultation within 5 days with a nonreferring physician. Conclusions and Relevance This survey study showed that patients with LTCs had limited access to remote modalities to interact with their referring physician for follow-up care, and patients considered replacing an in-person with a remote consultation even with another physician depending on the situation and the length of delay. Further research is needed to investigate the effective integration of remote care into the health care system in ways that maintain patient-centered care and improve patient outcomes.