Telemedicine docs who diagnose children less likely to follow prescribing guidelines for antibiotics
Children are more likely to be overprescribed antibiotics for common ailments, such as colds, sinus infections and sore throats when using telemedicine compared to in-person visits with primary care providers or urgent care facilities, suggests a study published in the current issue of Pediatrics.
The National Institutes of Health (NIH) yesterday acknowledged the study and said that telemedicine – a burgeoning trend that can increase access to healthcare for millions of people via audio-video conferencing on home computers and handheld devices – might lead physicians to prescribe antibiotics unnecessarily.
The new research, based on the billing data of more than 4,600 telemedicine encounters, suggests that physician-prescribing practices for pediatric patients may differ from those that happen during traditional office visits.
According to the study findings, out of 4604 telemedicine visits, 38,408 urgent care visits, and 485,201 primary care visits for children up to 17 years old with respiratory infections, children were more likely to receive prescriptions for antibiotics during telemedicine visits (52%), compared to urgent care visits (42%) and visits with primary care providers (31 percent).
However, clinical guidelines for antibiotic prescriptions were less likely to be followed after telemedicine visits (59%), compared to urgent care (67%) or primary care visits (78%). The clinical guidelines are intended to prevent inappropriate use of antibiotics, such as to treat viral infections for which they are ineffective, and to guide selection of the most appropriate antibiotic for bacterial infections. Inappropriate antibiotic use increases bacterial resistance to these drugs, eventually making many infections difficult to treat.
In conclusion, the study authors think maybe physicians providing telemedicine visits overprescribe antibiotics because they cannot closely examine patients or perform tests, potentially limiting their ability to distinguish between bacterial and viral infections.
