An Increase in Antibiotic Prescribing for Respiratory Tract Infections Through Telehealth Consultations: Retrospective Study in Australian General Practice

A study conducted in the early stage of the pandemic showed lower rates of medication prescriptions via telehealth compared to face-to-face consultations in Australian general practice [4]; however, antibiotic prescribing for RTIs by consultation modality is yet to be explored. [...]we examined antibiotic prescribing for RTIs via telehealth in comparison with face-to-face consultations from April 2020 to November 2021. To obtain our variables of interest, diagnosis data were used to identify consultations for respiratory infections based on SNOMED-CT (Systematized Nomenclature of Medicine – Clinical Terms) codes (respiratory infection, [viral/bacterial/recurrent/acute] upper respiratory tract infection, and [viral/bacterial/recurrent/acute] lower respiratory tract infection); antibiotic prescriptions were identified via the Anatomical Therapeutic Chemical code J01 (antibacterials for systemic use) in prescription data; and consultation modality was defined based on service item numbers from Medicare billing data [5]. Variables Estimated probability (%) of receiving antibiotic prescription (95% CI) 2020 2021 Age group (years) < 10 54.2 (52.0-56.6) 54.7 (53.0-56.4) 10-24 50.5 (47.6-53.6) 59.1 (56.3-62.0) 25-44 61.6 (58.9-64.5) 67.7 (65.9-69.6) 45-64 74.6 (71.2-78.1) 73.2 (71.0-75.5) ≥65 93.4 (87.7-99.4) 83.3 (80.3-86.5) Sex Female 65.2 (63.4-66.9) 66.9 (65.5-68.2) Male 58.0 (56.2-59.8) 65.6 (64.1-67.1) Active status Nonactive 48.9 (47.2-50.7) 51.9 (50.3-53.6) Active 65.2 (63.4-66.9) 66.9 (65.5-68.2) Remoteness Major cities 65.2 (63.4-66.9) 66.9 (65.5-68.2) Regional or remote areas 75.8 (72.1-79.7) 77.3 (74.9-79.7) Previous encounter (≤2 weeks) No 65.2 (63.4-66.9) 66.9 (65.5-68.2) Yes 63.6 (61.9-65.3) 66.5 (65.2-67.9) State New South Wales 65.2 (63.4-66.9) 67.7 (66.4-69.1) Victoria 54.6 (52.9-56.4) 66.9 (65.5-68.2) Consultation Face to face 65.2 (63.4-66.9) 66.9 (65.5-68.2) Telehealth 59.3 (57.6-61.0) 65.7 (64.4-67.0) Discussion Antibiotic prescribing via telehealth increased over time, with rates initially much lower than face-to-face consultations; however, the prescribing rates between the two consultation modalities became equivalent toward the end of 2021.