Patient Attitudes Toward Telehealth in Primary Health Care: A Qualitative Evidence Synthesis for Sustainable and Quality-Oriented Digital Transformation

Telehealth has become a central component of digital transformation in primary health care. Although its operational benefits are well documented, a clearer understanding of patient attitudes is essential for ensuring patient-centred, equitable, and sustainable service delivery. This study aimed to explore and synthesise adult patients’ attitudes toward telehealth in primary health care, with particular attention to perceived benefits, experienced difficulties, and contextual influences on acceptance. This study was designed as a qualitative evidence synthesis and reported in accordance with the ENTREQ statement. Systematic searches were conducted in PubMed/MEDLINE, Scopus, and Web of Science to identify peer-reviewed qualitative studies published in English between 1 January 2025 and 31 December 2025. Eligible studies examined adult patients’ experiences, perceptions, or attitudes regarding telehealth in primary care or primary-care-linked services. The study selection process was documented in accordance with the PRISMA framework. Data were synthesised through thematic synthesis, including line-by-line coding, development of descriptive themes, and generation of higher-order analytical interpretations. Seventeen studies were included. The synthesis showed that telehealth was generally perceived as a valuable but conditional mode of care. Patients particularly valued improved access, convenience, reduced travel burden, and support for follow-up and self-management. At the same time, they reported important concerns related to limited physical examination, communication quality, impersonality, technical difficulties, and uneven digital capability. Attitudes were strongly shaped by telehealth modality, consultation purpose, continuity of care, prior patient–clinician relationships, and social and technological conditions. Adult patients’ attitudes toward telehealth in primary health care are nuanced and context-dependent rather than uniformly positive or negative. Sustainable integration of telehealth requires more than technological availability; it depends on relational continuity, clear communication, clinical appropriateness, and equitable digital access. Telehealth is most likely to be accepted when implemented as part of a hybrid, patient-centred primary care model.