Antibiotic Prescribing for Respiratory Tract Infections and Encounter Length: An Observational Study of Telemedicine

Letters19 February 2019Antibiotic Prescribing for Respiratory Tract Infections and Encounter Length: An Observational Study of TelemedicineKathryn A. Martinez, PhD, MPH, Mark Rood, MD, Nikhyl Jhangiani, MPH, MBA, Adrienne Boissy, MD, and Michael B. Rothberg, MD, MPHKathryn A. Martinez, PhD, MPHCleveland Clinic, Cleveland, Ohio (K.A.M., M.R., N.J., A.B., M.B.R.), Mark Rood, MDCleveland Clinic, Cleveland, Ohio (K.A.M., M.R., N.J., A.B., M.B.R.), Nikhyl Jhangiani, MPH, MBACleveland Clinic, Cleveland, Ohio (K.A.M., M.R., N.J., A.B., M.B.R.), Adrienne Boissy, MDCleveland Clinic, Cleveland, Ohio (K.A.M., M.R., N.J., A.B., M.B.R.), and Michael B. Rothberg, MD, MPHCleveland Clinic, Cleveland, Ohio (K.A.M., M.R., N.J., A.B., M.B.R.)Author, Article, and Disclosure Informationhttps://doi.org/10.7326/M18-2042 SectionsAboutFull TextPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareFacebookTwitterLinkedInRedditEmail Background: Outpatient respiratory tract infections (RTIs) rarely warrant antibiotics, although they are frequently prescribed (1). Because patients often expect to receive antibiotics (2), physicians may believe that explaining why they are unnecessary is more time-consuming than simply prescribing them. Of 2 studies that assessed this concept in the outpatient setting (3, 4), only 1 found that antibiotic receipt was associated with shorter visits after adjustment for other factors (3). Respiratory tract infections are the predominant reason that patients seek care in the rapidly expanding care setting of direct-to-consumer (DTC) telemedicine. The telemedicine system automatically records encounter length, making it an ...References1. Fleming-Dutra KE, Hersh AL, Shapiro DJ, Bartoces M, Enns EA, File TM, et al. Prevalence of inappropriate antibiotic prescriptions among US ambulatory care visits, 2010-2011. JAMA. 2016;315:1864-73. [PMID: 27139059] doi:10.1001/jama.2016.4151 CrossrefMedlineGoogle Scholar2. Welschen I, Kuyvenhoven M, Hoes A, Verheij T. Antibiotics for acute respiratory tract symptoms: patients' expectations, GPs' management and patient satisfaction. Fam Pract. 2004;21:234-7. [PMID: 15128681] CrossrefMedlineGoogle Scholar3. Imanpour S, Nwaiwu O, McMaughan DK, DeSalvo B, Bashir A. Factors associated with antibiotic prescriptions for the viral origin diseases in office-based practices, 2006-2012. JRSM Open. 2017;8:2054270417717668. [PMID: 28811907] doi:10.1177/2054270417717668 CrossrefMedlineGoogle Scholar4. Linder JA, Singer DE, Stafford RS. Association between antibiotic prescribing and visit duration in adults with upper respiratory tract infections. Clin Ther. 2003;25:2419-30. [PMID: 14604741] CrossrefMedlineGoogle Scholar5. Martinez KA, Rood M, Jhangiani N, Kou L, Boissy A, Rothberg MB. Association between antibiotic prescribing for respiratory tract infections and patient satisfaction: an observational study of direct to consumer telemedicine. JAMA Intern Med. 2018. [Forthcoming]. CrossrefGoogle Scholar Author, Article, and Disclosure InformationAffiliations: Cleveland Clinic, Cleveland, Ohio (K.A.M., M.R., N.J., A.B., M.B.R.)Disclosures: Authors have disclosed no conflicts of interest. Forms can be viewed at www.acponline.org/authors/icmje/ConflictOfInterestForms.do?msNum=M18-2042.Reproducible Research Statement:Study protocol and statistical code: Not available. Data set: Available from Dr. Martinez (e-mail, [email protected]org).This article was published at Annals.org on 2 October 2018. PreviousarticleNextarticle Advertisement FiguresReferencesRelatedDetailsSee AlsoAntibiotic Prescribing for Respiratory Tract Infections and Encounter Length Carl Llor , Marie Boël , Gloria Cordoba , and Lars Bjerrum Antibiotic Prescribing for Respiratory Tract Infections and Encounter Length Kathryn A. Martinez and Michael B. 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Metlay, MD, PhD and Katrina A. Armstrong, MD, MSShedding Light on Telemedicine & Online Prescribing: The Need to Balance Access to Health Care and Quality of CareThe Current and Future Use of Telemedicine in Infectious Diseases PracticePatient Satisfaction and Antibiotic Prescribing for Respiratory Infections by TelemedicinePediatric TelehealthThe Doctor-of-the-Future Is In: Patient Responses to Disruptive Health-Care InnovationsTelemedicine encounter length for RTIs similar with no antibiotics 19 February 2019Volume 170, Issue 4Page: 275-277KeywordsAntibioticsBronchitisInstitutional review boardsInternational Classification of DiseasesObservational studiesOutpatientsPatientsPharyngitisTelemedicineUpper respiratory tract infections ePublished: 2 October 2018 Issue Published: 19 February 2019 Copyright & PermissionsCopyright © 2018 by American College of Physicians. All Rights Reserved.PDF downloadLoading ...