Private GP video consulting 'could increase antibiotic prescribing'

Companies offering video consulting with private GPs could threaten efforts to reduce inappropriate antibiotic prescribing, researchers have said.

Video consulting is particularly acceptable to younger patients, but its safety and effectiveness remain largely untested. | iStock
Video consulting is particularly acceptable to younger patients, but its safety and effectiveness remain largely untested. | iStock

A study published in the Journal of the Royal Society of Medicine has highlighted the potential negative impact of private GP video consulting on efforts to reduce antibiotic prescribing.

Using the online register of the Care Quality Commission, researchers at Imperial College London identified seven private companies offering video consultations with GPs. Four of the seven specified on their websites that they would prescribe antibiotics.

None of the websites included information about the appropriate use of antibiotics, differences between viral and bacterial or self-limiting conditions, or antibiotic stewardship.

The study highlighted a number of factors that could increase prescribing of antibiotics during video consultations.

'The uncertainty inherent in video consulting, where examination is impossible, might be expected to result in increased antibiotic prescription, due to clinicians feeling a need to ‘play it safe’,' say the authors.

Patient expectations and a GP’s perception of these play a key role in antibiotic prescribing. Advertisements suggesting that video consulting services offer easy access to antibiotics may result in patients having higher expectations of receiving these drugs and therefore increased pressure on GPs to prescribe them.

The researchers found that common internet searches such as ‘get antibiotics’, ‘prescribe antibiotics’ and ‘buy antibiotics’ all returned as the top result, an advertising link to a GP video consultation service promising an antibiotic prescription ‘in minutes’.

Prescribing of antibiotics is also known to be associated with increased patient satisfaction, and in a competitive online environment, private companies would be reliant on positive patient feedback, say the researchers.

Safety concerns

Although video consulting offers face-to-face interaction, the study authors expressed concern that the inability to carry out a physical examination or further investigations could affect the safety of assessments. They also pointed out that private online GPs lack access to NHS patient records, posing a risk of missing vital information regarding allergies, interactions or test results. 

However, said the authors, 'this novel mode of patient access also has potential for patient education, [by] improving health literacy on infection, antibiotics and antimicrobial resistance, where it is currently lacking.'

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