Patient outcomes in face-to-face clinics compared to virtual clinics for initial varicose vein consultations

Background: The community prevalence of chronic venous insufficiency is high while complication rates of untreated varicose veins are relatively low. This prevalence / severity disparity leads to large numbers of patients awaiting routine clinic appointments for evaluation of their venous disease. Virtual consultations may partially alleviate this issue. We aimed to determine whether there was in difference in patient outcomes between those seen in a traditional ‘face-to-face’ clinic model compared to those consulted remotely by telephone. Methods: A prospective multi-site cohort study involved random allocation of six hundred ‘non-urgent’ referrals to virtual or face to face appointments for initial consultation regarding varicose veins. Results: Initial virtual consultations for varicose veins were as effective as face-to-face consultations with respect to patient consultation outcomes. Similar proportions, about one-third, of face-to-face and virtual patients opted for surgical intervention (p =.726), compression hosiery (p =.17) or surveillance (p =.296). Factors including pain, phlebitis, ulcers and leg swelling may influence patients’ willingness to utilise virtual consultations. Conclusions: Virtual consultations provided an equally effective method of delivering initial consultations for varicose veins while facilitating patients for whom travelling long distances poses a challenge.