Clinicians More Likely to Prescribe Antibiotic on Telephone Than In Person
Issues Raised on Telemedicine Antibiotic Prescribing in Study
A new RAND Corporation Study has shown that patients are more likely to be prescribed an antibiotic for an acute respiratory infection by a doctor on a telephone or live video than face-to-face for the same illness. Findings from the study are published in JAMA Internal Medicine.
In this first-of-its-kind study to evaluate the quality of direct-to-consumer telemedicine vs. face-to-face care for common acute respiratory infections, about 1,700 patient "visits" for an acute respiratory infection from April 2012 to October 2013 by Teladoc were compared to about 64,000 patients who visited a doctor's office for a similar medical issue.
Patients examined virtually were more likely to be prescribed a broad-spectrum antibiotic, in which the overuse of the drugs can increase costs and contribute to antibiotic resistance. Both settings, however, showed high rates of inappropriate prescribing for some conditions, which support prior studies that conclude about half of outpatient antibiotic prescriptions are not clinically necessary.
RAND researchers conclude that the greater use of broad-spectrum antibiotics by the telemedicine doctors may be a due to the direct-to-consumer companies operating conservatively, based on limited diagnostic information about their patients.
Telemedicine providers should consider quality-improvement initiatives to modify physicians' behavior, and to educate patients to influence demand for unnecessary antibiotics.
For more information visit RAND.org.