NIH: In direct-to-consumer telemedicine visits people use
their personal devices to connect with doctors. Using telemedicine for
children, particularly for acute problems like respiratory tract infections,
can be harmful.
The situations include colds, sore throats, and ear
infections. Kids may not be able to describe their symptoms. Specific physical
exams or tests might also be needed that aren’t possible during telemedicine
visits. For example, diagnosing an ear infection requires the doctor to look
inside the ear canal. Diagnosing strep throat requires a strep test.
A team led by Dr. Kristin Ray at the University of
Pittsburgh compared the quality of care delivered to children via telemedicine
with that at urgent care facilities and during primary care visits. The team
used 2015–2016 claims data from a large national health plan to assess how
frequently doctors prescribed antibiotics to children for respiratory
infections.
More than 5,000 children with respiratory infections
received care via telemedicine, about 88,000 at urgent care, and more than 1
million by primary care doctors.
The team tallied the antibiotics dispensed within 2 days
for each type of visit. The research was supported by NIH’s Eunice Kennedy
Shriver National Institute of Child Health and Human Development (NICHD).
Results appeared online on April 8, 2019, in Pediatrics.
Among visits matched by patient and visit characteristics,
the team found that doctors prescribed antibiotics for respiratory infections
at 52% of telemedicine visits, 42% of urgent care visits, and 31% of primary
care visits.
Next, the team analyzed whether antibiotics were
prescribed according to clinical guidelines for the diagnoses received. Only
59% of telemedicine visits met the guidelines, compared with 67% of urgent care
visits and 78% of primary care visits.
Primary care and urgent care settings provide higher
quality care for respiratory infections than direct-to-consumer telemedicine.
Not seeing a patient physically can be an important cause
of AMR.
Dr KK Aggarwal
Padma Shri Awardee
President Elect Confederation of
Medical Associations in Asia and Oceania
(CMAAO)
Group Editor-in-Chief IJCP Publications
President Heart Care Foundation of
India
Past National President
IMA
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