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healthy soch
New Delhi, April 25, 2019 ;
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.
The author of this article is Dr KK Aggarwal, Padma Shri Awardee
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