Multidrug stewardship and adherence to guidelines in >200,000 direct-to-consumer Telemedicine encounters

Area of Science:

• Infectious Diseases
• Health Services Research
• Digital Health

Background:

• Telemedicine quality and safety are linked to judicious medication prescribing.
• Adherence to COVID-19 guidelines is crucial for managing respiratory infections via telemedicine.
• Multidrug stewardship protocols aim to optimize antibiotic use.

Purpose of the Study:

• To assess adherence to COVID-19 guidelines in telemedicine encounters.
• To evaluate the impact of multidrug stewardship protocols on prescribing practices.
• To analyze medication prescription rates for respiratory infections managed through telemedicine.

Main Methods:

• Retrospective study of telemedicine encounters for respiratory symptoms (March 2020 - August 2021).
• Analysis of electronic medical records for quality indicators and prescription patterns.
• Physician feedback based on personal metrics and adherence to Infectious Diseases Society of America guidelines.

Main Results:

• Over 221,000 patients evaluated; 19% had confirmed COVID-19, 47% suspected COVID-19.
• Low antibiotic prescription rates: 0.46% for confirmed COVID-19, 0.65% for suspected COVID-19.
• Minimal non-evidence-based prescriptions (≤0.01%).

Conclusions:

• Guideline training and telemedicine feedback reduce antibiotic and antimicrobial prescriptions.
• Multidrug stewardship protocols improve adherence to guidelines in telemedicine.
• Enhanced quality of care and patient safety observed in telemedicine encounters.