Providers treating patients through direct-to-consumer telehealth services were more likely to prescribe costly, antibiotic resistance medication than in-person doctors, according to the recent findings of a research study.
The RAND Corporation, a Santa Monica, Calif.-based nonprofit organization, compared antibiotic prescribing rates for acute respiratory infection between Teladoc, a direct-to-consumer telemedicine company, and physician offices.
What they found was physicians in both settings were prescribing the same amount of antibiotics, however, direct-to-consumer telehealth doctors had higher rates of "inappropriate" prescribing for bronchitis and other respiratory conditions.
Specifically, the telehealth doctors were prescribing broad-spectrum antibiotics at a higher rate. Ninety-four percent of Teladoc physicians prescribed broad-spectrum antibiotics for bronchitis, compared to 76 percent of in-person physicians. For sinusitis, it was a 85 percent of Teladoc physicians and 50 percent of in-person physicians. Broad-spectrum antibiotic prescriptions are costlier and contribute to antibiotic resistance, the researchers say. They expressed concern that the higher use of broad-spectrum antibiotics by the telemedicine doctors may be a result of direct-to-consumer companies practicing conservatively, based upon limited diagnostic information about their patients.
“The pattern of treatment offered to patients who saw a physician face-to-face versus those who spoke with a physician on the telephone was not substantially different,” states Lori Usher-Pines, the study’s lead author and a policy researcher at RAND, a nonprofit research organization. “However, we found the antibiotics prescribed during telemedicine ‘visits’ raised some specific quality concerns that require further attention.”
The research was published in JAMA Internal Medicine.