Telemedicine significantly improves antibiotic prescribing for UTIs, study finds
Virtual care for uncomplicated UTI was associated with more appropriate antimicrobial prescribing and a decrease in diagnostic testing and use of follow-up resources compared with in-person office visits, according to a recent study.
The study, which was conducted in a primary care network with 44 outpatient sites, “add[s] further support to the growing evidence surrounding virtual visits as a tool to improve antibiotic prescribing in the outpatient setting,” researchers wrote.
“Our institution previously evaluated the same virtual visit platform’s impact on appropriate diagnosis and prescribing for sinusitis,” Kaitlyn L. Johnson, PharmD, a pharmacy resident at Mercy Health Muskegon in Michigan, told Healio. “We observed a significant improvement in the appropriate diagnosis of viral sinusitis and corresponding decrease in antibiotic prescribing in patients treated through virtual visits. We wanted to know if we would find similar findings using the same platform with a different diagnosis.”
Johnson and colleagues conducted a retrospective cohort study to compare how closely clinicians followed the network’s antimicrobial stewardship programs guidelines when conducting virtual visits or office visits for uncomplicated UTI. They compared prescribing in both settings, including agent, duration and patient outcomes.
In total, 350 female patients were included in the study 175 in the virtual group and 175 in the office visit group. The study demonstrated that patients treated for a UTI through a virtual visit were more likely to receive a first-line antibiotic agent (74.9% vs. 59.4%; P = .002) and guideline-concordant duration (100% vs, 53.1%; P < .001). Additionally, the researchers found that patients treated through virtual visits were less likely to have a urinalysis (0% vs. 97.1%; P < .001) or urine culture (0% vs. 73.1%; P < .001) ordered and were less likely to revisit for follow-up within 7 days (5.1% vs. 18.9%; P < .001).
Johnson and colleagues suggested that prescribing was improved during telemedicine visits because the virtual visit platform includes a drop-down menu of antibiotic choices, each with a “fixed, but guideline-appropriate, duration of therapy which could not be altered within the virtual platform.”