GP provider Docly, along with its Swedish counterpart Min Doktor, is adding its support in the battle against antibiotic resistance.
Antibiotics
Public health campaigns such as “Keep antibiotics working” have tried to educate patients as to the dangers of incorrect antibiotic use, but GPs still face this question on a near-daily basis.
Rates of GP prescribing of antibiotics have fallen 17.3% between 2014 and 2018, Public Health England figures show. Min Doktor has shown that rate reductions can go much further than this, prescribing antibiotics up to 50% less than Sweden’s national average. Presented at the RCGP Annual Conference, the study analysed three years’ of urinary tract infection (UTI) antibiotic prescription data against the Swedish national average.
The study found significantly lower rates of antibiotic prescriptions per 1,000 patients per year in the Min Doktor service compared to reported rates in physical care. Nearly 115 out of 1,000 cases diagnosed with UTI were treated with antibiotics under the care of Min Doktor, under half of the 296 observed in Sweden.
Broad spectrum antibiotics were also examined and shown to be used at lower levels than the Swedish average.
In February 2019, professor Helen Stokes-Lampard, chair of the Royal College of General Practitioners, said: “GPs are in an incredibly difficult position when it comes to antibiotics prescribing. We are under huge pressure not to prescribe – and publicly vilified when we are deemed to do so too readily – yet, we know that in some cases antibiotics are a matter of life or death. Getting the balance right every time is extremely challenging.”
Docly uses pre-consultation tools, consisting of treatment specific questionnaires with in-built triage, provide the GP with enough information to be specific about which antibiotic to use. Condition specific decision support and guidelines then allow the GP to follow a structured protocol for each treatment area. This may be behind the decreased use of quinolines as compared to those used in face to face consultations in Sweden.
A GP-patient message thread can remain open for a day or two if required. The cautious “just in case” prescription, necessary in traditional practice to prevent a second appointment, can be avoided.
Caroline Pilot, chief medical officer said: “GPs work incredibly hard to ensure that antibiotic prescribing is appropriate. However, the data suggests that a text-based consultation, backed up by decision support, can help to ensure that antibiotics are reserved only for cases whereby they are necessary and will provide benefit. We look forward to working with practices to support their workforce to provide safe and quality-assured care.”