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Primary care rapidly adjusted delivery of care at the onset of the COVID-19 pandemic. This often meant operating a “closed-door” policy, implementing new ways of working and switching to remote consultations. Pre-pandemic, remote consultations were limited but the pandemic necessitated rapid adoption of new approaches, often resulting in changes in the management of patients.

Key challenges

Implementation of remote consultations posed a number of challenges. While they were implemented to minimise risk of infection for both patients and clinicians, they also introduced potential clinical risk related to a clinician “missing something” due to lack of opportunity for a physical examination.  Research also showed that with time, PCPs found remote consultations to be more time-consuming, clinically challenging, and less satisfying. 

In the context of RTI symptoms, these issues have been further magnified by the uncertainty in assessing respiratory and/or related COVID-19 symptoms remotely.  Studies highlighted that PCPs found it difficult to assess whether and when patients will deteriorate and changing guidance on typical and atypical COVID-19 symptoms was difficult to implement. In addition, HCPs also had to make decisions whether or not patients should be prescribed antibiotics. The emerging evidence is mixed, with some studies showing that some PCPs prescribed more antibiotics when not being able to see patients as part of safety netting. Similarly, studies show that patients may have managed their infections at home as a result of the pandemic and may have sought help from other sources such as helplines or pharmacists. Patient views on the need for physical examination, need for antibiotics and diagnostic testing may have changed as a result of the pandemic. However, while both HCPs and patients were managing RTI infections in a particular way during the pandemic, it is unclear what these changes may mean long-term. It is important to explore these issues from both HCP and patient perspectives. Based on these findings, the work may focus on developing interventions supporting management of RTIs in primary care to fit future consultation models.

What are we looking for?

This doctoral opportunity will enable the student to focus on the management of RTIs in primary care. The project will be shaped by student’s interests but is likely involve a programme of work encompassing:

  • Systematic review of current evidence related to management of RTIs in the context of COVID-19
  • Qualitative or mixed-methods study looking at views of patients and HCPs on management of RTIs in primary care
  • Development of an intervention supporting patients and/or HCPs in managing RTIs in primary care to fit future consultation models.

Who should apply?

The selected student will be able to develop methodological experience in systematic reviews, questionnaire/survey design and qualitative data collection, and complex intervention design.  

The project will suit a student with interest in healthcare delivery research; qualitative research, and mixed methods. Candidates will be expected to be familiar with the basics of evidence synthesis, and quantitative and qualitative research methodology as applied to healthcare settings and to hold a good undergraduate degree and a Masters degree in a relevant subject (such as clinical exercise science, public health, evidence-based health care, communications science, behavioural science).