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Treating pediatric conjunctivitis without an exam: An evaluation of outcomes and antibiotic usage
Kristine S Penza1,2, Martha A Murray1,2, Jane F Myers2
1Mayo Clinic Express Care, USA.
Insights
Non-face-to-face visits for pediatric conjunctivitis, including eVisits and phone calls, showed significantly higher follow-up rates than in-person retail clinic visits. Antibiotic prescribing was higher with phone calls but similar between eVisits and in-person visits.
Area of Science:
- Pediatric healthcare
- Infectious disease management
- Telemedicine and digital health
Background:
- Pediatric conjunctivitis is a common condition requiring appropriate management and follow-up.
- Traditional in-person visits may present barriers to timely follow-up care.
- The rise of telemedicine offers alternative avenues for healthcare delivery.
Purpose of the Study:
- To compare antibiotic treatment, follow-up rates, and follow-up encounter types for pediatric conjunctivitis across eVisits, phone calls, and in-person retail clinic visits.
- To evaluate the effectiveness of different healthcare encounter modalities in managing pediatric conjunctivitis.
Main Methods:
- Retrospective chart review of pediatric patients diagnosed with conjunctivitis from May 2016 to May 2017.
- Analysis of 101 eVisits, 202 in-person retail clinic visits, and 202 nurse phone calls.
- Comparison of follow-up rates, follow-up encounter types within 14 days, and antibiotic prescribing rates among the three encounter types.
Main Results:
- Non-face-to-face encounters (eVisits and phone calls) had significantly higher follow-up rates (34.6% and 45.5%) compared to in-person retail clinic visits (7.4%).
- Antibiotic treatment rates were significantly higher in phone call encounters (41.6%) than in eVisits (25.7%) or in-person visits (19.8%).
- Follow-up location varied: eVisit patients were more likely to follow up at retail clinics, while phone call patients typically followed up in primary care offices.
Conclusions:
- Non-face-to-face healthcare encounters demonstrate superior follow-up rates for pediatric conjunctivitis compared to traditional in-person visits.
- Phone call triage is associated with increased antibiotic prescribing, whereas eVisits and in-person visits showed similar antibiotic prescribing rates.
- The modality of the initial encounter influences the type and location of subsequent follow-up care.
Objective:
The objective of this research paper is to compare antibiotic treatment, follow-up rates, and types of follow-up encounters among eVisits, phone calls, and in-person encounters for pediatric conjunctivitis.
Study Design:
A retrospective chart review of pediatric patients evaluated for conjunctivitis between May 1, 2016 and May 1, 2017, was performed. A total of 101 eVisits, 202 in-person retail clinic visits, and 202 nurse phone calls for conjunctivitis were manually reviewed for outcomes. Exclusion criteria included previous encounter for conjunctivitis in the past 14 days, treatment with an oral antibiotic at the initial encounter, or patient outside Minnesota at the time of encounter. Comparison among the three encounter types with regard to follow-up rates, follow-up encounter type within 14 days of initial evaluation, and prescribing rates was performed.
Results:
Patients completing non-face-to-face encounters were significantly more likely to have follow-up care (34.6% and 45.5%) than those who had a face-to-face visit at the retail clinic (7.4%), p ≤ 0.0001. Patients initially evaluated by eVisit were more likely to have follow-up at the retail clinic while patients initially evaluated by phone call were more likely to have follow-up in their primary care office. Treatment rates with antibiotics were significantly higher in phone call encounters (41.6%) than in eVisits (25.7%) or face-to-face encounters (19.8%), p < 0.0001.
Conclusions:
Non-face-to-face visits have significantly higher rates of follow-up when compared to face-to-face encounters. Antibiotic prescribing is greater with phone call triage encounters; however, there was no significant difference in antibiotic prescribing rates between eVisits and face-to-face visits. Follow-up type varied according to site of initial encounter.
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