Impact of Remote Consultations on Antibiotic Prescribing in Primary Health Care: Systematic Review
BackgroundThere has been growing international interest in performing remote consultations in primary care, particularly amidst the current COVID-19 pandemic. Despite this, the evidence surrounding the safety of remote consultations is inconclusive. The appropriateness of ant...
Main Authors: | , , , |
---|---|
Format: | Article |
Language: | English |
Published: |
JMIR Publications
2020-11-01
|
Series: | Journal of Medical Internet Research |
Online Access: | http://www.jmir.org/2020/11/e23482/ |
id |
doaj-82b13fc21e5d486b91a834669ed8b568 |
---|---|
record_format |
Article |
spelling |
doaj-82b13fc21e5d486b91a834669ed8b5682021-04-02T21:36:02ZengJMIR PublicationsJournal of Medical Internet Research1438-88712020-11-012211e2348210.2196/23482Impact of Remote Consultations on Antibiotic Prescribing in Primary Health Care: Systematic ReviewHan, Seung MinGreenfield, GevaMajeed, AzeemHayhoe, Benedict BackgroundThere has been growing international interest in performing remote consultations in primary care, particularly amidst the current COVID-19 pandemic. Despite this, the evidence surrounding the safety of remote consultations is inconclusive. The appropriateness of antibiotic prescribing in remote consultations is an important aspect of patient safety that needs to be addressed. ObjectiveThis study aimed to summarize evidence on the impact of remote consultation in primary care with regard to antibiotic prescribing. MethodsSearches were conducted in MEDLINE, Embase, HMIC, PsycINFO, and CINAHL for literature published since the databases’ inception to February 2020. Peer-reviewed studies conducted in primary health care settings were included. All remote consultation types were considered, and studies were required to report any quantitative measure of antibiotic prescribing to be included in this systematic review. Studies were excluded if there were no comparison groups (face-to-face consultations). ResultsIn total, 12 studies were identified. Of these, 4 studies reported higher antibiotic-prescribing rates, 5 studies reported lower antibiotic-prescribing rates, and 3 studies reported similar antibiotic-prescribing rates in remote consultations compared with face-to-face consultations. Guideline-concordant prescribing was not significantly different between remote and face-to-face consultations for patients with sinusitis, but conflicting results were found for patients with acute respiratory infections. Mixed evidence was found for follow-up visit rates after remote and face-to-face consultations. ConclusionsThere is insufficient evidence to confidently conclude that remote consulting has a significant impact on antibiotic prescribing in primary care. However, studies indicating higher prescribing rates in remote consultations than in face-to-face consultations are a concern. Further, well-conducted studies are needed to inform safe and appropriate implementation of remote consulting to ensure that there is no unintended impact on antimicrobial resistance.http://www.jmir.org/2020/11/e23482/ |
collection |
DOAJ |
language |
English |
format |
Article |
sources |
DOAJ |
author |
Han, Seung Min Greenfield, Geva Majeed, Azeem Hayhoe, Benedict |
spellingShingle |
Han, Seung Min Greenfield, Geva Majeed, Azeem Hayhoe, Benedict Impact of Remote Consultations on Antibiotic Prescribing in Primary Health Care: Systematic Review Journal of Medical Internet Research |
author_facet |
Han, Seung Min Greenfield, Geva Majeed, Azeem Hayhoe, Benedict |
author_sort |
Han, Seung Min |
title |
Impact of Remote Consultations on Antibiotic Prescribing in Primary Health Care: Systematic Review |
title_short |
Impact of Remote Consultations on Antibiotic Prescribing in Primary Health Care: Systematic Review |
title_full |
Impact of Remote Consultations on Antibiotic Prescribing in Primary Health Care: Systematic Review |
title_fullStr |
Impact of Remote Consultations on Antibiotic Prescribing in Primary Health Care: Systematic Review |
title_full_unstemmed |
Impact of Remote Consultations on Antibiotic Prescribing in Primary Health Care: Systematic Review |
title_sort |
impact of remote consultations on antibiotic prescribing in primary health care: systematic review |
publisher |
JMIR Publications |
series |
Journal of Medical Internet Research |
issn |
1438-8871 |
publishDate |
2020-11-01 |
description |
BackgroundThere has been growing international interest in performing remote consultations in primary care, particularly amidst the current COVID-19 pandemic. Despite this, the evidence surrounding the safety of remote consultations is inconclusive. The appropriateness of antibiotic prescribing in remote consultations is an important aspect of patient safety that needs to be addressed.
ObjectiveThis study aimed to summarize evidence on the impact of remote consultation in primary care with regard to antibiotic prescribing.
MethodsSearches were conducted in MEDLINE, Embase, HMIC, PsycINFO, and CINAHL for literature published since the databases’ inception to February 2020. Peer-reviewed studies conducted in primary health care settings were included. All remote consultation types were considered, and studies were required to report any quantitative measure of antibiotic prescribing to be included in this systematic review. Studies were excluded if there were no comparison groups (face-to-face consultations).
ResultsIn total, 12 studies were identified. Of these, 4 studies reported higher antibiotic-prescribing rates, 5 studies reported lower antibiotic-prescribing rates, and 3 studies reported similar antibiotic-prescribing rates in remote consultations compared with face-to-face consultations. Guideline-concordant prescribing was not significantly different between remote and face-to-face consultations for patients with sinusitis, but conflicting results were found for patients with acute respiratory infections. Mixed evidence was found for follow-up visit rates after remote and face-to-face consultations.
ConclusionsThere is insufficient evidence to confidently conclude that remote consulting has a significant impact on antibiotic prescribing in primary care. However, studies indicating higher prescribing rates in remote consultations than in face-to-face consultations are a concern. Further, well-conducted studies are needed to inform safe and appropriate implementation of remote consulting to ensure that there is no unintended impact on antimicrobial resistance. |
url |
http://www.jmir.org/2020/11/e23482/ |
work_keys_str_mv |
AT hanseungmin impactofremoteconsultationsonantibioticprescribinginprimaryhealthcaresystematicreview AT greenfieldgeva impactofremoteconsultationsonantibioticprescribinginprimaryhealthcaresystematicreview AT majeedazeem impactofremoteconsultationsonantibioticprescribinginprimaryhealthcaresystematicreview AT hayhoebenedict impactofremoteconsultationsonantibioticprescribinginprimaryhealthcaresystematicreview |
_version_ |
1721545079838998528 |