Telemedicine visits increase overprescription of antibiotics for children

Researchers at UPMC Children’s Hospital found that pediatric patients with acute respiratory infections were prescribed antibiotics more often during virtual visits than in-person appointments.

Their analysis of claims data in a national health plan database, published on Monday in the journal Pediatrics, show that children received antibiotic prescriptions during 52 percent of telemedicine visits, compared with 42 percent of urgent care and 31 percent of primary care visits.

In addition, UPMC researchers discovered that clinical guidelines for antibiotic prescriptions were only followed 59 percent of the time after telemedicine visits, while 67 percent of the time urgent care and 78 percent of the time primary care visits followed the guidelines.

The study’s author conclude that when it comes to direct-to-consumer telemedicine visits, children with acute respiratory infections “were more likely to receive antibiotics and less likely to receive guideline-concordant antibiotic management, compared to children at PCP visits and urgent care visits.”

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The study was funded by the Eunice Kennedy Shriver National Institute of Child Health and Human Development, which is part of the National Institutes of Health.

According to NIH, the study’s authors “theorize that physicians providing telemedicine visits may overprescribe antibiotics because they cannot closely examine patients or perform tests, potentially limiting their ability to distinguish between bacterial and viral infections.”

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“Insurers are increasingly offering telemedicine—with 96 percent of large business insurance plans now offering coverage—and as a result, millions of children now have access, and our prior work found that use is rapidly increasing,” says lead author Kristin Ray, MD, pediatrician in the Division of General Academic Pediatrics at UPMC Children's Hospital.

“As a general pediatrician, I’m interested in making care easier and less burdensome for families, and I think there are many technological innovations that aim to do this, but I think it also is important to make sure the quality of the care that children receive remains high,” added Ray.

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