Delivery of person-centred virtual care for middle-aged and older adults: A mixed methods systematic review of patient and healthcare professional perceptions.

OBJECTIVES

Virtual care is a core component of health systems worldwide. However, the operationalisation of person-centred care (PCC) in virtual settings remains fragmented across populations and service contexts. Middle-aged (45-64 years) and older adults (≥ 65 years) may face digital, cognitive, and contextual barriers that influence engagement with virtual services. This mixed methods systematic review examined how PCC can be delivered through virtual consultations for this population.

METHODS

MEDLINE, Embase, CINAHL, and PsycINFO were searched from inception to June 2024, supplemented by reference list and citation searching. Eligible studies included qualitative, quantitative, and mixed methods studies involving adults aged ≥ 45 years and/or healthcare professionals in one-to-one virtual consultations addressing at least one dimension of PCC. Two reviewers independently screened, extracted, and appraised studies using the Mixed Methods Appraisal Tool. A convergent integrated approach was undertaken, whereby quantitative findings were transformed into qualitative data and synthesised thematically with qualitative findings to generate themes.

RESULTS

Of 1141 records (1134 through database searches and seven through reference list and citation searches), 41 studies were included. Six interrelated components underpinning person-centred virtual care were identified: (1) digital access and literacy; (2) telepresence and perceived connection; (3) secure and trustworthy systems; (4) therapeutic relationships and virtual consultation structure; (5) digital communication, collaboration, and autonomy; and (6) readiness, preferences, and contextual factors.

CONCLUSIONS

Person-centred virtual care for middle-aged and older adults is achievable when digital readiness and clinical suitability are assessed individually, care is adapted to patient needs and preferences, and relational and clinical quality are supported by competent healthcare professionals and enabling organisational systems.

PRACTICE IMPLICATIONS: The findings provide guidance for clinicians, healthcare organisations, and policymakers to strengthen communication, accessibility, and equity in virtual care. They may inform training, service design, and organisational strategies that support tailored, relational, and clinically appropriate care for this population.