Objective: To study whether an online fertility workup with video consultation is noninferior to a regular consultation with face-to-face contact in terms of patient-centeredness and shared decision-making.
Design: A nonblinded randomized controlled single-center trial.
Patient(s): New, treatment-naïve patients with infertility.
Intervention: The online fertility workup consists of online recommendations for diagnostic tests (based on an anamnesis questionnaire) and performing the tests before a 30-minute video consultation compared with a hospital-based fertility workup with face-to-face appointments. The study interventions took place during the COronaVIrus Disease of 2019 (COVID-19) pandemic.
Main outcome measures: The primary outcome measure for this study was the level of patient centeredness as measured with the Patient-Centredness Questionnaire - Infertility. Secondary outcome measures were, among others, the level of "Shared decision-making" as measured with the CollaboRATE questionnaire and information on waiting times and technical issues. For more in-depth and qualitative information about the online fertility workup, semistructured interviews were held.
Results: The mean patient-centeredness score was 2.66 for the online workup group with video consultation vs. 2.56 for the control group, on a scale of 0-3. The mean difference between the total score and the different subscales varied between 0.01 and 0.1, thus meeting the noninferiority criteria of 0.3. There were no significant differences in the experienced levels of shared decision-making between the 2 groups. The majority of the intervention group had a preparation time of less than 5 minutes, whereas more than half of the control group spent 60-90 minutes on their appointment in the hospital. In 17% of the video consultations, there were some technical issues. During the interviews, patients expressed positive experiences with the online workup and video consultation in different themes, for example, the patient-physician relationship, expressing their emotions and communication. However, some expressed their preference for a face-to-face consultation for "bad news."
Conclusion: This study showed that an online fertility workup with video consultation is noninferior to a regular fertility workup in terms of patient centeredness and shared decision-making. Important advantages of an online fertility workup were the reduced travel time and patients' feelings of a more personalized and discrete healthcare setting and possibilities for more sustainable healthcare options.
Clinical trial registration number: NL8554, https://onderzoekmetmensen.nl/en/trial/27046.
Keywords: Video consultation; online healthcare; patient centeredness; shared decision-making.
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