Telemedicine linked to fewer unnecessary antibiotic prescriptions

The reduced reliance on ‘just in case’ antibiotic prescriptions marks an important improvement at a time when antimicrobial resistance is one of the world’s most pressing public health issues.

According to the World Health Organisation (WHO), antimicrobial resistance contributed to close to an estimated five million deaths globally in 2019 and inappropriate antibiotic use is a key driver, meaning even small improvements in prescribing can have a meaningful effect at population scale.

During the pandemic telemedicine saw rapid and widespread growth in Australia, with policy change immediately implemented to support availability of remote consultations through universal healthcare.  Between March and September 2020, 25 million telemedicine consultations were delivered, representing one in four GP visits during the seven-month period.

While the number of telemedicine appointments has levelled, it is now embedded in routine primary care delivery and accounts for around one in seven primary care consultations nationwide making its long-term effects on care quality an important area for investigation.

The findings provide some of the strongest real-world evidence to date on how remote consultations are influencing GP decision making in primary care, examining GP behaviour before, during and after the height of the pandemic.

The study co-authors include Deakin Business School Associate Research Fellow Dr Maria Wisniewska, Professor Daniel Avdic from University of Technology Sydney, Dr Johannes Kunz from Monash University and Dr Susan J Méndez from University of Melbourne.

Potential explanations for the reduction in antibiotic prescriptions include:

• telemedicine making it easier for GPs to arrange quick follow-up appointments reducing the need for ‘just in case’ prescribing
• decreased reliance on antibiotics as a time-saving tool due to improved efficiency of consultations
• reduction in perceived pressure felt in face-to-face settings
• increased choice of healthcare providers, not limited to geographical access, leading to improved matches between patients and physicians.

With governments and health services now considering the long-term role of telemedicine within Medicare, the study offers timely insights.

While recognising telemedicine brings both opportunities and challenges with clinicians losing access to some diagnostic cues without a physical examination, the study indicates the efficiencies and flexibility of remote care may help reduce unnecessary prescribing.

‘Telemedicine is here to stay, and its long-term impact on quality and safety has been a largely unanswered question,’ said Dr Wisniewska.

‘Our findings suggest that remote consultations can actually support more appropriate antibiotic use, which is a critical public health priority.’

‘This study helps build the evidence base for how telemedicine can be safely integrated into routine care and provides much-needed data as we consider the future of primary health and telemedicine services.’

To view the full published study visit: Does telemedicine technology affect prescribing quality in primary care? The case of antibiotics - ScienceDirect