{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,30]],"date-time":"2026-06-30T23:49:13Z","timestamp":1782863353229,"version":"3.54.5"},"reference-count":73,"publisher":"BMJ","issue":"2","license":[{"start":{"date-parts":[[2025,9,25]],"date-time":"2025-09-25T00:00:00Z","timestamp":1758758400000},"content-version":"unspecified","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/501100001923","name":"Health Services Research Programme","doi-asserted-by":"publisher","award":["NIHR153151"],"award-info":[{"award-number":["NIHR153151"]}],"id":[{"id":"10.13039\/501100001923","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["Sex Transm Infect"],"accepted":{"date-parts":[[2025,5,27]]},"published-print":{"date-parts":[[2026,3]]},"abstract":"<jats:sec>\n                    <jats:title>Objectives<\/jats:title>\n                    <jats:p>Timely access to sexual health screening and contraception is an important public health issue. Substantial funding reductions for sexual and reproductive health services (SRHS) and COVID-19 have led to significant changes in service delivery, including the rapid introduction of remote consultations, as a substitute for in-person contact. There is limited evidence relating to the barriers to remote consultations and how these may impact sexual health outcomes and wider health inequalities. This study synthesises existing evidence on remote consultations to examine effectiveness, cost-effectiveness, experiences, access and equity.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>Eighteen electronic databases were systematically searched to locate relevant studies published from OECD (Organisation for Economic Co-operation and Development) countries after 2010. The Mixed Methods Appraisal Tool was used to evaluate the quality of the studies.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Out of 8690 studies identified, 48 met the inclusion criteria. The included studies were heterogeneous and covered a range of topics; however, few focused on health inequalities and remote consultations, with satisfaction and quality of care being the most common outcome measures. Many of the studies were completed post-2020 in response to COVID-19 and were of medium to low quality. Access to technology and communication challenges were found to impact inequality when accessing SRHS via remote consultations, although they enhance convenience for service users and service providers.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Overall, the review shows that a range of studies have investigated remote consultations in SRHS, but there remains limited evidence on the impact on health inequalities and sexual health outcomes. The surge in post-2020 research, spurred by COVID-19, indicates the necessity for further high-quality research into equitable SRHS delivery in the post-COVID era, particularly in addressing technological and communication barriers. There is a need to further optimise access and the delivery of remote consultations in SRHS, considering the needs of service users, and minimising inequality (observed differences) and inequity (unfair differences).<\/jats:p>\n                    <jats:p>CRD42023397288.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1136\/sextrans-2024-056458","type":"journal-article","created":{"date-parts":[[2025,9,25]],"date-time":"2025-09-25T17:25:39Z","timestamp":1758821139000},"page":"109-122","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":4,"title":["Remote consultations in sexual and reproductive health services: a systematic review of evidence on effectiveness, cost-effectiveness, experiences, access and equity"],"prefix":"10.1136","volume":"102","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-2841-6505","authenticated-orcid":false,"given":"Charlotte","family":"Spurway","sequence":"first","affiliation":[{"name":"Health Economics Unit, School of Health Sciences, College of Medicine and Health, University of Birmingham, Birmingham, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Iestyn","family":"Williams","sequence":"additional","affiliation":[{"name":"Health Services Management Centre, School of Social Policy and Society, University of Birmingham, Birmingham, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2097-8949","authenticated-orcid":false,"given":"Oluseyi Cyril","family":"Ayinde","sequence":"additional","affiliation":[{"name":"Whittall Street Clinic, University Hospitals Birmingham NHS Foundation Trust, Birmingham, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Christian","family":"Bohm","sequence":"additional","affiliation":[{"name":"Health Services Management Centre, School of Social Policy and Society, University of Birmingham, Birmingham, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9105-2441","authenticated-orcid":false,"given":"Fiona","family":"Burns","sequence":"additional","affiliation":[{"name":"Institute for Global Health, University College London, London, UK"},{"name":"Royal Free London NHS Foundation Trust, London, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5696-0260","authenticated-orcid":false,"given":"Jo","family":"Gibbs","sequence":"additional","affiliation":[{"name":"Institute for Global Health, University College London, London, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jo","family":"Josh","sequence":"additional","affiliation":[{"name":"PPIE Lead, London, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Helen","family":"Munro","sequence":"additional","affiliation":[{"name":"Hywel Dda University Health Board, Carmarthen, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Melvina","family":"Woode Owusu","sequence":"additional","affiliation":[{"name":"Institute for Global Health, University College London, London, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4177-1832","authenticated-orcid":false,"given":"Danielle","family":"Solomon","sequence":"additional","affiliation":[{"name":"Institute for Global Health, University College London, London, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jonathan DC","family":"Ross","sequence":"additional","affiliation":[{"name":"Whittall Street Clinic, University Hospitals Birmingham NHS Foundation Trust, Birmingham, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8492-0020","authenticated-orcid":false,"given":"Louise J","family":"Jackson","sequence":"additional","affiliation":[{"name":"Health Economics Unit, School of Health Sciences, College of Medicine and Health, University of Birmingham, Birmingham, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"239","published-online":{"date-parts":[[2025,9,25]]},"reference":[{"key":"2026021702100703000_102.2.109.1","unstructured":"World Health Organisation . Global health sector strategies on, respectively, HIV, viral hepatitis and sexually transmitted infections for the period 2022-2030. World Health Organisation; 2022."},{"key":"2026021702100703000_102.2.109.2","doi-asserted-by":"crossref","DOI":"10.1136\/sextrans-2011-050108.224","article-title":"P1-S5.46\u2005Assessing the relationship between sexually transmitted infection rates, ethnic group and socio-economic deprivation in England","volume":"87","author":"Savage","year":"2011","journal-title":"Sex Transm Infect"},{"key":"2026021702100703000_102.2.109.3","unstructured":"Office for National Statistics . Conceptions in England and Wales: 2018. 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Digital inclusion guide for health and social care. NHS Digital; 2019."},{"key":"2026021702100703000_102.2.109.14","doi-asserted-by":"crossref","DOI":"10.1136\/bmj.m3945","article-title":"Video consultations in primary and specialist care during the covid-19 pandemic and beyond","volume":"371","author":"Car","year":"2020","journal-title":"BMJ"},{"key":"2026021702100703000_102.2.109.15","doi-asserted-by":"crossref","unstructured":"Greenhalgh T , Rosen R , Shaw SE , et al . Planning and Evaluating Remote Consultation Services: A New Conceptual Framework Incorporating Complexity and Practical Ethics. Front Digit Health 2021;3. doi:10.3389\/fdgth.2021.726095","DOI":"10.3389\/fdgth.2021.726095"},{"key":"2026021702100703000_102.2.109.16","doi-asserted-by":"publisher","DOI":"10.3399\/BJGP.2021.0028"},{"key":"2026021702100703000_102.2.109.17","doi-asserted-by":"crossref","unstructured":"Irmak E , Bozdal M . 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