Medication Dispensing Patterns Following Teleconsultations in France From January 2021 to June 2023: A Retrospective Cohort Study Using the National Health Data System

Background: Teleconsultation services grew significantly in France during the COVID-19 pandemic. Reimbursed teleconsultations increased by a hundredfold between 2019 and 2021, establishing it as an emerging healthcare delivery modality. However, medication dispensing patterns following teleconsultations remain largely unexplored. This study aimed to characterize post-teleconsultation medication dispensing patterns between 2021 and 2023. Methods: A retrospective cohort study was conducted using data from the French health database. The study included all teleconsultations conducted that resulted in at least one medication dispensing event (TLCs) between January 1, 2021, and June 30, 2023. We described patient demographics, prescriber characteristics, and dispensed medication. Results: During the study period, 11 202 364 TLCs (34.3%) out of 33 853 911 resulted in medication dispensing. Among these 11 202 364 TLCs, the patient population predominantly comprised females (64.4%), individuals without long-term medical conditions (86.4%), with a mean age of 42.2 years (SD ± 20.8). Teleconsultations were mainly conducted by liberals’ physicians (86.8%) and health centre-employed practitioners (12.1%). The use of teleconsultation platforms increased fivefold between the first semesters 2021 (4.2%) and 2023 (28.2%). Teleconsultations resulted in medications targeting the nervous system (53.1%), digestive system (28.3%), and respiratory system (21.8%). Two contexts of dispensing emerged: dispensing with chronic indication (42.8% of TLCs) characterized by a long median time and several dispensing, and dispensing with an acute indication (55.6%), characterized by single dispensing with a 0-1 day between teleconsultation and dispensing. Conclusion: One third of the teleconsultations resulted in medication dispensing, mainly for young, urban patients with good access to care, in contrast to the objective as described in the French Law. Dispensing patterns revealed two distinct modalities, acute symptomatic and chronic disease management. Certain classes of drugs dispensed (antibiotics, opioids, benzodiazepines) may raise questions about appropriate dispensing practices in teleconsultations.