Evaluating the effect of digital primary care on antibiotic prescription : Evidence using Swedish register data
Wilkens, Jens LU ; Thulesius, Hans LU ; Arvidsson, Eva and Ekman, Björn LU
(2023)
In Digital Health
9.
- Abstract
Background: The growing use of digital primary care consultations has led to concerns about resource use, equity and quality. One of these is how it affects antibiotic prescription. Differences in ease of access for patients and available diagnostic information for the prescribing physicians are reasons to believe prescription rates may be affected. Objectives: We estimated differences in antibiotic prescription between traditional office-based and digital contacts, if these differences varied between groups of diagnoses depending on the availability of information for the prescribing physician, and if differences were associated with socio-demographic patient characteristics. Methods: Using individual level register data for a sample... (More)
Background: The growing use of digital primary care consultations has led to concerns about resource use, equity and quality. One of these is how it affects antibiotic prescription. Differences in ease of access for patients and available diagnostic information for the prescribing physicians are reasons to believe prescription rates may be affected. Objectives: We estimated differences in antibiotic prescription between traditional office-based and digital contacts, if these differences varied between groups of diagnoses depending on the availability of information for the prescribing physician, and if differences were associated with socio-demographic patient characteristics. Methods: Using individual level register data for a sample of patients diagnosed with an infection over a two-year period, we estimated differences in prescription between the two types of contacts and applied propensity score techniques to mitigate possible problems with treatment selection bias. Results: The share of antibiotic prescription was 28 (95% CI 27–30, p < 0.001) to 33 (95% CI 29–36, p < 0.001) percentage points lower among digital contacts as compared to office-based contacts. For urinary tract infections, the differences in prescription rates between the two contact types were smaller (34 to 41 percentage points difference) than for throat and skin infections (50 to 60 percentage points difference). For women, rural, older, and people born outside Sweden, digital contacts were associated with higher prescription rates. Conclusions: Antibiotic prescription rates were significantly lower for digital contacts compared with office-based contacts. The findings suggest that digital primary care may be an effective alternative to in-person visits without undue consequences for antibiotic prescription levels, although to varying degree depending on diagnosis.
(Less)
- author
- Wilkens, Jens
LU
; Thulesius, Hans
LU
; Arvidsson, Eva
and Ekman, Björn
LU
- organization
- publishing date
- 2023
- type
- Contribution to journal
- publication status
- published
- subject
- keywords
- antibiotics prescriptions, digital contacts, Primary care, socioeconomic factors, Sweden
- in
- Digital Health
- volume
- 9
- publisher
- SAGE Publications
- external identifiers
-
- scopus:85148438602
- ISSN
- 2055-2076
- DOI
- 10.1177/20552076231156213
- language
- English
- LU publication?
- yes
- id
- cf8239e9-1e11-434f-8947-04b2d7afafe9
- date added to LUP
- 2023-03-07 14:44:17
- date last changed
- 2024-06-21 02:16:12
@article{cf8239e9-1e11-434f-8947-04b2d7afafe9,
abstract = {{<p>Background: The growing use of digital primary care consultations has led to concerns about resource use, equity and quality. One of these is how it affects antibiotic prescription. Differences in ease of access for patients and available diagnostic information for the prescribing physicians are reasons to believe prescription rates may be affected. Objectives: We estimated differences in antibiotic prescription between traditional office-based and digital contacts, if these differences varied between groups of diagnoses depending on the availability of information for the prescribing physician, and if differences were associated with socio-demographic patient characteristics. Methods: Using individual level register data for a sample of patients diagnosed with an infection over a two-year period, we estimated differences in prescription between the two types of contacts and applied propensity score techniques to mitigate possible problems with treatment selection bias. Results: The share of antibiotic prescription was 28 (95% CI 27–30, p < 0.001) to 33 (95% CI 29–36, p < 0.001) percentage points lower among digital contacts as compared to office-based contacts. For urinary tract infections, the differences in prescription rates between the two contact types were smaller (34 to 41 percentage points difference) than for throat and skin infections (50 to 60 percentage points difference). For women, rural, older, and people born outside Sweden, digital contacts were associated with higher prescription rates. Conclusions: Antibiotic prescription rates were significantly lower for digital contacts compared with office-based contacts. The findings suggest that digital primary care may be an effective alternative to in-person visits without undue consequences for antibiotic prescription levels, although to varying degree depending on diagnosis.</p>}},
author = {{Wilkens, Jens and Thulesius, Hans and Arvidsson, Eva and Ekman, Björn}},
issn = {{2055-2076}},
keywords = {{antibiotics prescriptions; digital contacts; Primary care; socioeconomic factors; Sweden}},
language = {{eng}},
publisher = {{SAGE Publications}},
series = {{Digital Health}},
title = {{Evaluating the effect of digital primary care on antibiotic prescription : Evidence using Swedish register data}},
url = {{http://dx.doi.org/10.1177/20552076231156213}},
doi = {{10.1177/20552076231156213}},
volume = {{9}},
year = {{2023}},
}