Direct-to-consumer telemedicine in primary care settings: a scoping review of contemporary empirical literature

Background and objectives
This study comprehensively reviews the contemporary empirical literature on direct-to-consumer (DTC) telemedicine services within primary care.

Methods
MEDLINE, Embase and SCOPUS were strategically searched and screened. Data on the modality of consultations, population of focus, condition of focus and treatment of focus were extracted, narratively synthesised and tabulated.

Results
Forty-four articles were included in this review. Most used quantitative methods, with predominantly cross-sectional or retrospective cohort designs. DTC telemedicine user characteristics and perspectives were most researched, followed by quality and safety. Most services used video or text messaging. Articles typically examined a specific health condition (eg acute respiratory infections) and its treatment, and several focused on a specific population (eg men).

Discussion
In light of the poor evidence base and lack of rigorous studies, there is a critical need for more robust research on DTC telemedicine within primary care. Quality assessment tool development and health economics analyses are necessary to support the integratation of DTC telemedicine services with traditional primary care systems and improve primary healthcare quality and efficiency.