Rullier Cécile, Tarazona Vincent, De Bandt David
Family medicine department, University of Paris Saclay, Versailles-Saint-Quentin-en-Yvelines, Paris, France.
Family medicine department, University of Paris Saclay, Versailles-Saint-Quentin-en-Yvelines, Paris, France
BJGP Open. 2024 Jul 29;8(2). doi: 10.3399/BJGPO.2023.0196. Print 2024 Jul.
In patients with infectious diseases, remote consultation (RC) may be questionable compared with face-to-face office consultation (OC), not only because of the lack of physical examination but also because of the risk of overprescribing antibiotics (ATBs).
To analyse ATB prescription in OC versus RC in a sample of French GPs.
DESIGN & SETTING: This is a retrospective observational cohort study in general practice in 2021. Anonymised data were collected from voluntary GPs.
The influence of the mode of consultation on ATB prescription was analysed using a χ² test. A secondary multivariate analysis investigated the factors influencing the use of OC or RC in patients who received at least one ATB.
In total, 35 503 consultations with an identifiable rating were included, corresponding to seven doctors' activities, practising with five locums and three residents. ATBs were prescribed in 10.41% of RCs and 6.77% of OCs (<0.01). RC was associated with more frequent prescription of ATBs for respiratory and ear, nose, and throat (ENT) viral infections and urinary tract infections. For patients aged 20-40 years, ATB prescription was more associated with RC.
RC is associated with a more frequent ATB prescription than OC, mostly for patients aged 20-40 years, who are most likely to use new technologies; and for urinary tract infections or respiratory and ENT viral infections. Further studies on RC outcomes should be conducted to better analyse the impact of RC on the prescribing of ATBs.
在传染病患者中，与面对面的门诊咨询（OC）相比，远程咨询（RC）可能存在问题，这不仅是因为缺乏体格检查，还因为存在过度开具抗生素（ATB）的风险。
分析法国全科医生样本中OC与RC的ATB处方情况。
这是一项2021年全科医疗的回顾性观察队列研究。从自愿参与的全科医生处收集匿名数据。
使用χ²检验分析咨询方式对ATB处方的影响。二次多变量分析调查了在至少接受一剂ATB的患者中影响使用OC或RC的因素。
总共纳入了35503次可识别评级的咨询，对应七位医生的活动，包括五名临时全科医生和三名住院医生的执业情况。RC中10.41%的患者开具了ATB，OC中这一比例为6.77%（<0.01）。RC与呼吸道、耳鼻喉（ENT）病毒感染及尿路感染的ATB处方更频繁相关。对于20 - 40岁的患者，ATB处方与RC的关联更强。
与OC相比，RC与更频繁的ATB处方相关，主要针对20 - 40岁最有可能使用新技术的患者，以及尿路感染或呼吸道及耳鼻喉病毒感染患者。应进一步开展关于RC结果的研究，以更好地分析RC对ATB处方的影响。
