Shannon van Hoorn

184 Chapter 6 during the consultation regardless if the patient completed the generic quality of life questionnaire before their consultation. To mitigate the potential influence of both the inexperience of the medical students and the selection bias, it was important to obtain data saturation. Data saturation was reached after 28 interviews when no new insights were gained in the patients experiences with the implemented changes at the HIV outpatient clinic. In this study, we specifically focused on obtaining data saturation in the experiences of both patients that completed the generic quality of life questionnaire and patients whom did not complete the questionnaire. This increased the generalizability of our results and ensured that the results of this study are representative of the current patient population of the HIV outpatient clinic. Lastly, the care provision at the HIV outpatient clinic was diverse before the interventions were implemented. Some patients already received a separate consultation with the nurse consultant/practitioner and ID specialist every year before this annual double consultation was structurally implemented at the HIV outpatient clinic. In addition, because of the COVID-19 pandemic most patients gained experience with a remote consultation, since this was the only way in which care could be continued. During the pandemic remote consultations became an acceptable substitute for a face-to-face consultation23,24. The diversity in care provision and use of remote consultations before the changes were implemented at the HIV outpatient clinic might have positively influenced patients experiences and their attitude towards the changes. Implications for further research and practice This study shows that the implemented VBHC interventions were received positively by the patients of the HIV outpatient clinic of the Erasmus MC. This finding can be used to inform other healthcare professionals and organizations wishing to implement VBHC or to increase the value of the patient-healthcare professional interaction. Especially the patients’ positive attitude towards the implementation of the generic quality of life questionnaire is promising since this is often seen as essential to providing optimal individualized HIV care 4,25,26. In this study patients mentioned that the fixed time of a video consultation was one of the reasons they preferred a video above a telephone consultation. It would be interesting to assess the possibility and implications of scheduling

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