Antibiotic Prescribing for Acute Respiratory Infections in Direct-to-Consumer Telemedicine Visits

Published in: JAMA Internal Medicine, v. 175, no. 7, July 2015, p. 1234-1235. doi:10.1001/jamainternmed.2015.2024

Posted on RAND.org on March 28, 2017

by Lori Uscher-Pines, Andrew W. Mulcahy, David Cowling, Gerald P. Hunter, Rachel M. Burns, Ateev Mehrotra

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Research Question

  1. Do in-office physicians prescribe antibiotics for acute respiratory infection differently than Teledoc (telemedicine) providers?

Patterns of antibiotic prescribing behavior show that both telemedicine and office-based clinicians over-prescribed antibiotics to treat acute respiratory infections, but telemedicine clinicians tended to prescribe broad-spectrum antibiotics.

Key Findings

  • Overall, antibiotics were prescribed at about the same rate by office-based physicians and Teledoc providers.
  • Both settings had high rates of antibiotics prescribed inappropriately for conditions such as bronchitis.
  • Teledoc providers prescribed broad-spectrum antibiotics more often than office-based physicians, which may be a conservative practice in response to having little diagnostic information.
  • Timely feedback to physicians could help adjust provider behavior, and patient educational campaigns could help reduce consumer demand.

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