Article Text

Original research
Factors that influence patient preferences for virtual consultations in an orthopaedic rehabilitation setting: a qualitative study
  1. Anthony W Gilbert1,2,3,
  2. Jeremy Jones2,
  3. Maria Stokes2,4,
  4. Carl R May3,5
  1. 1 Therapies Department, Royal National Orthopaedic Hospital Stanmore, Stanmore, UK
  2. 2 Faculty of Health Sciences, University of Southampton, Southampton, UK
  3. 3 NIHR Applied Research Collaboration, North Thames, UK
  4. 4 NIHR Applied Research Collaboration, Wessex, UK
  5. 5 Faculty of Public Health and Policy, London School of Hygiene and Tropical Medicine, London, UK
  1. Correspondence to Anthony W Gilbert; anthony.gilbert{at}


Objectives To identify, characterise and explain factors that influence patient preferences, from the perspective of patients and clinicians, for virtual consultations in an orthopaedic rehabilitation setting.

Design Qualitative study using semi-structured interviews and abductive analysis.

Setting A physiotherapy and occupational therapy department situated within a tertiary orthopaedic centre in the UK.

Participants Patients who were receiving orthopaedic rehabilitation for a musculoskeletal problem. Occupational therapists, physiotherapists or therapy technicians involved in the delivery of orthopaedic rehabilitation for patients with a musculoskeletal problem.

Results Twenty-two patients and 22 healthcare professionals were interviewed. The average interview length was 48 minutes. Four major factors were found to influence preference: the situation of care (the ways that patients understand and explain their clinical status, their treatment requirements and the care pathway), the expectations of care (influenced by a patients desire for contact, psychological status, previous care and perceived requirements), the demands on the patient (due to each patients respective social situation and the consequences of choice) and the capacity to allocate resources to care (these include financial, infrastructural, social and healthcare resources).

Conclusion This study has identified key factors that appear to influence patient preference for virtual consultations in orthopaedic rehabilitation. A conceptual model of these factors, derived from empirical data, has been developed highlighting how they combine and compete. A series of questions, based on these factors, have been developed to support identification of preferences in a clinical setting.

  • qualitative research
  • orthopaedic & trauma surgery
  • health services administration & management

This is an open access article distributed in accordance with the Creative Commons Attribution 4.0 Unported (CC BY 4.0) license, which permits others to copy, redistribute, remix, transform and build upon this work for any purpose, provided the original work is properly cited, a link to the licence is given, and indication of whether changes were made. See:

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  • Twitter @awgilbert11

  • Contributors AWG wrote the paper and conceived the project with CRM, JJ and MS. CRM guided qualitative data collection. AWG conducted all the interviews. CRM assisted with data analysis, and with AWG developed the model. CRM, JJ and MS edited and critically revised the paper. All authors have read and approved the manuscript. AWG is the guarantor of the manuscript.

  • Funding Anthony Gilbert is funded by a National Institute for Health Research (NIHR), Clinical Doctoral Research Fellowship for this research project (ICA-CDRF-2017-03-025). Anthony Gilbert and Carl May are supported by the NIHR ARC North Thames. The views expressed in this publication are those of the author(s) and not necessarily those of the NIHR or the Department of Health and Social Care.

  • Competing interests None declared.

  • Patient consent for publication Not required.

  • Ethics approval Ethical approval was received for this study (approval received on 4 December 2018 from the South Central-Oxford C Research Ethics Committee (IRAS ID: 255172, REC Reference 18/SC/0663)). All participants were provided with a participant information sheet and given at least 24 hours to consider the information and ask questions before being recruited into the study. All participants provided informed, written consent prior to enrolment.

  • Provenance and peer review Not commissioned; externally peer reviewed.

  • Data availability statement Data are available upon reasonable request. Data are available upon reasonable request from the corresponding author.

  • Supplemental material This content has been supplied by the author(s). It has not been vetted by BMJ Publishing Group Limited (BMJ) and may not have been peer-reviewed. Any opinions or recommendations discussed are solely those of the author(s) and are not endorsed by BMJ. BMJ disclaims all liability and responsibility arising from any reliance placed on the content. Where the content includes any translated material, BMJ does not warrant the accuracy and reliability of the translations (including but not limited to local regulations, clinical guidelines, terminology, drug names and drug dosages), and is not responsible for any error and/or omissions arising from translation and adaptation or otherwise.