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Accessing care for Long Covid from the perspectives of patients and healthcare practitioners: A qualitative study

Turk, Fidan; Sweetman, Jennifer; Chew-Graham, Carolyn A; Gabbay, Mark; Shepherd, Jessie; van der Feltz-cornelis, Christina; (2024) Accessing care for Long Covid from the perspectives of patients and healthcare practitioners: A qualitative study. Health Expectations , 27 (2) , Article e14008. 10.1111/hex.14008. Green open access

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Abstract

Background: Long Covid is an emerging long-term condition, with those affected raising concerns about lack of healthcare support. Objective: We conducted a qualitative study to identify facilitators and barriers to healthcare access for people with Long Covid, aiming to enhance our understanding of the specific nature of these barriers and how patient experiences may vary. Setting and Participants: In the context of the Symptoms, Trajectory, Inequalities and Management: Understanding Long-COVID to Address and Transform Existing Integrated Care Pathways (STIMULATE-ICP) Delphi study, a nationally distributed online survey was conducted. Eight patients and eight healthcare practitioners (HCP) were interviewed via telephone or video call. Framework analysis, sensitised by the candidacy theory, was used to identify barriers and facilitators over four levels of access to care. Results: Three themes were identified: (i) patients' efforts to navigate emerging pathways for Long Covid, (ii) the patient–HCP interaction and (iii) service resources and structural constraints. Barriers to specialist care included long waiting times, communication gaps across services and a lack of continuity in care. Facilitators included collaborative, patient-centred approaches, patients' active role in their healthcare and blended approaches for appointments. The perspectives of both patients and HCPs largely aligned. Discussion: The candidacy framework was valuable in understanding the experiences of people with Long Covid seeking access to healthcare. Individuals perceived themselves as eligible for care, but they often encountered obstacles in obtaining the expected level of care or, in some cases, did not receive it at all. Our findings are discussed in the context of the candidacy model through multiple processes of identification, negotiation, permeability and appearances at health services. These themes seem to be especially important for the emerging new pathway model and are relevant to both primary and secondary care. Conclusions: This study highlights that despite these interviews being conducted two years after the start of the COVID-19 pandemic, people with Long Covid still struggle to access healthcare, emphasising the ongoing need to provide equitable timely healthcare access for people with Long Covid. Patient or Public Contribution: People with Long Covid advised on all stages of this research.

Type: Article
Title: Accessing care for Long Covid from the perspectives of patients and healthcare practitioners: A qualitative study
Location: England
Open access status: An open access version is available from UCL Discovery
DOI: 10.1111/hex.14008
Publisher version: http://dx.doi.org/10.1111/hex.14008
Language: English
Additional information: This is an open access article under the terms of the Creative Commons Attribution License, which permits use, distribution and reproduction in any medium, provided the original work is properly cited. © 2024 The Authors. Health Expectations published by John Wiley & Sons Ltd.
Keywords: Science & Technology, Life Sciences & Biomedicine, Health Care Sciences & Services, Health Policy & Services, Public, Environmental & Occupational Health, access to care, lived experiences, Long Covid, long-term conditions, multiple symptoms, qualitative study, waiting times
UCL classification: UCL
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Population Health Sciences > Institute of Health Informatics
URI: https://discovery.ucl.ac.uk/id/eprint/10193423
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