Digital Online Consultations - Effects on Antibiotic Prescribing and Health Care Utilization in Primary Care

Summary

BACKGROUND/SIGNIFICANCE: With developments in mobile health and the abundance of smartphones, online consultations have emerged as a popular form of primary care in Sweden. Controversy exists regarding diagnostic accuracy, appropriate prescription of antibiotics, and effects on care-seeking patient behavior following implementation of online consultations. As empirical research is lacking, the investigators seek to evaluate online primary care consultations compared to physical consultations with regards to non-inferiority of antibiotic prescription for chief complaint of sore throat.

METHODS: Medical record data is used to identify patients with a chief complaint of sore throat, cough/common cold/influenza, or dysuria after choosing online (DIGI) or physical (PHYSI) consultations. A cohort of patients with similar chief complaints prior to implementation of online consultations was used as a control group (CONTROL). Prospective data from local registries and medical records was gathered 14 days the consultation. The primary outcome was rate of antibiotic prescription after sore throat. Secondary outcomes included patient revisits (including hospital admissions), patient satisfaction, time to physician contact, registered diagnosis, and documentation or Centor Criteria and Urinary Tract Infection (UTI)-Criteria.

SIGNIFICANCE: Results will shed light on whether antibiotic prescription differs significantly between digital and physical primary care consultations. Hypotheses may also be generated as to how patients seek care in light of improved availability in a tax-sponsored healthcare system.

Conditions

• Sore Throat
• Dysuria
• Cough
• Common Cold
• Influenza

Interventions

OTHER

Physical Consultation

Regular physician consultation at the primary care clinic.

OTHER

Online Consultation

An online platform for communicating with a physician digitally. Patients answer a series of algorithm-based questions after specifying chief complaint, after which contact is established with a physician who can communicate through short messages. The physician can then order labs, prescribe relevant medication or book the patient for a physical consultation if need be.

Sponsors & Collaborators

• Doctrin

  collaborator UNKNOWN

• Capio Group

  collaborator OTHER

• Capio Go

  collaborator UNKNOWN

• Lund University

  collaborator OTHER

• Region Skane

  lead OTHER

Principal Investigators

• Jan Sundkvist, Professor · CPF, Department of Clinical Sciences, Malmö

Eligibility

Min Age

18 Years

Sex

ALL

Healthy Volunteers

No

Timeline & Regulatory

Start

2018-03-30

Primary Completion

2019-12-06

Completion

2021-12-20

Countries

• Sweden

Study Locations