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Kristin N. Ray
A study published in pediatrics revealed that children with acute respiratory infections treated at telemedicine visits directly to consumers are much more likely to receive antibiotics. According to the researchers, these children are also less likely to receive antimicrobial therapy based on recommendations.
Kristin N. Ray, MD, MS, Assistant Professor of Pediatrics at the University of Pittsburgh School of Medicine, said Infectious Diseases in Children that the results show that antimicrobial management should be a priority for telemedicine programs that treat acute childhood diseases.
The AAP recommends not using telemedicine directly to the consumer outside the medical center for acute care due to limited physical examinations, lack of patient-provider relationships and lack of access to all patient records. patients. In addition, the academy has expressed concerns about children's ability to express their symptoms.
The researchers conducted a retrospective cohort study using the claims data collected in a large national commercial health plan. Children aged 0 to 17 with acute respiratory infection, or ARI, were included in the badysis if they did not have other comorbidities that could affect antibiotic prescribing.
Primary care was the most commonly used type of health care for pediatric ARIs (n = 485,201), followed by urgent care (n = 38,408) and telemedicine DTC (n = 4,604). Children with ARI who used telemedicine DTC were prescribed antibiotics more often (52%) than those who used primary care (42%; P <0.001) and urgent care (31%; P <0.001).
In addition, children who had telemedicine consultations with a DTC were less likely to benefit from guideline-based antibiotic management (59%) than children in primary care (78%; P <0.001) or urgent care (78%; P <0.001).
The researchers wrote that these results contrasted with previous studies on the quality of telemedicine DTC, which included adult patients.
"As a parent, I understand the desire to receive accessible care at home, but we need to make sure that the care provided to children remains of high quality," Ray said. "It's important to constantly think about the diagnoses and symptoms that can and can not be well managed by telemedicine. The answers may be different for children than for adults. They can also be for home telemedicine or telemedicine in a health facility setting. I think it's important to apply antibiotic stewardship approaches to individual programs and physicians to guide continuous improvement, regardless of the context in which children receive care. of short time. "- by Katherine Bortz
Disclosures: The authors do not report any relevant financial information.
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