The analysis revealed that children received antibiotic prescriptions during 52% of telemedicine visits, compared with 42% of urgent care and 31% of the time a patient visited a doctor's office.
Children with acute respiratory infections (ARI) seen via telemedicine visits are far more likely to be overprescribed antibiotics than those who went to a doctor’s office or clinic, a new study by researchers at the UPMC Children’s Hospital of Pittsburgh states. The peer-reviewed article was published Monday on the scientific journal Pediatrics.
The team of experts analyzed over 530,000 cases from a database corresponding to a national insurance commercial health plan from 2015 to 2016. Their objective was to compare the quality of antibiotic prescribing for ARIs among children (0–17 years old) across three settings: telemedicine, urgent care, and a doctor’s office.
“In recent years, the use of telemedicine for acute, primary care concerns has increased among children,” said lead author Kristin Ray from the Division of General Academic Pediatrics at UPMC Children’s Hospital, adding that this is mainly due to insurers who “are increasingly offering telemedicine – with 96% of large business insurance plans now offering coverage.”
The analysis revealed that children received antibiotic prescriptions during 52% of telemedicine visits, compared with 42% of urgent care and 31% of the time a patient visited a doctor's office. As Tim Landers, an Ohio State University expert on antibiotic-resistant infections, told AP, this overprescribing of antibiotics not only builds resistance but it also can add a needless cost to medical bills and even cause serious side effects.
The researchers also found that 40 percent of telemedicine doctors failed to meet medical guidelines on matching treatment to diagnosis. That mainly had to do with physicians prescribing bacteria-fighting drugs to treat viral illnesses, such as colds and flu, which are unaffected by antibiotics; or not running a throat swab and lab test before diagnosing strep throat.
“I think there are many technological innovations but I think it also is important to make sure the quality of the care that children receive remains high,” Ray said.
As a recommendation, the American Academy of Pediatrics, which publishes the journal, encourages parents not to use such such telemedicine programs, as limited physical examinations and lack of access to patient records can harm care.