Children Diagnosed Via Telemedicine More Likely To be Given Drugs Instead Of Other Treatments Says Study


Children diagnosed through telemedicine are likely to receive antibiotic prescriptions than those who go through traditional consultations, a new study suggested.

Telemedicine has become a convenient alternative to in-person consultations. Not only is it cheap, but many insurance providers already cover it.

Although it can increase reimbursements, it will still be more affordable to pay than a visit to, say, the ER.

With it, the patient can seek an appointment anytime, anywhere. Doctors can be at their patient's bedside in minutes although virtually.

They also have different methods of communication from instant messaging to real-time video chats through applications such as Skype and FaceTime.

In spite of its popularity, not much is known about its health impacts, especially among the children. It is information the team from UPMC Children's Hospital of Pittsburgh wanted to find out.

More Antibiotics For the Children

To know the answer, the researchers looked into the data of around 340,000 insured children between 2015 and 2016.

They then narrowed the samples to children between 0 and 17 years old. These kids went to see their doctors in three settings: urgent care, primary care, and telemedicine.

They also received antibiotic prescriptions for their acute respiratory infection. The team excluded those who already had comorbidities that could potentially affect antibiotic decisions.

Overall, PCP visits were the highest at 485,201 followed by urgent care at 38,408. DTC telemedicine was the smallest at fewer than 5,000 visits.

However, children were prescribed antibiotics during 52 percent of their telemedicine sessions compared to only 31 percent of primary care and 42 percent of urgent care visits.

They further learned these kids may undergo antibiotic management that is not in accordance with the guidelines.

Spotting The Problems With Telemedicine

The over-prescription of antibiotics, especially when not within the management guidelines, can increase the risk of antibiotic resistance and superbugs.

Data from the World Health Organization revealed this global health problem is responsible for 700,000 deaths each year. By 2050, it can increase by 10 million fatalities.

Children may also develop more severe side effects, while parents may end up spending higher healthcare costs in the long term.

The researchers also noted discrepancies in the quality of care.

For example, the American Telemedicine Association discourages using DTC telemedicine on children below 2 years old. About 5 percent of the analyzed telemedicine visits involved kids within this age group.

Second, some types of ARIs require testing and visualization. For instance, a doctor may have to see the tympanic membrane to diagnose otitis media accurately.

"Making these diagnoses via telemedicine in the absence of reliable visualization and testing could in itself be considered a quality concern," said the study now published in Pediatrics.

The researchers do not undermine the benefits of technological innovations such as telemedicine to improve healthcare delivery.

"But I think it also is important to make sure the quality of the care that children receive remains high," noted Dr. Kristin Ray, lead author.

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