Video Consultations Have Great Potential but Require Further Testing

VIDEO consultations provide many potential benefits but further evidence is required to fully ascertain their effectiveness and safety in primary care, according to researchers from Imperial College London, London, UK. The team highlighted possible issues that may arise from such a system, including a higher number of prescriptions for antibiotics.

Key Priority
Greater utilisation of video consultations in the UK’s NHS is a key government priority to reduce pressure on the primary care system. There is also evidence that such a system is acceptable to patients, given the flexibility and convenience it provides them.

Antibiotic Prescription
However, the authors of this new study caution that the efficacy and safety of video consultations remain largely unvestigated. One major concern is that antibiotics could be prescribed inappropriately on a more regular basis, thus increasing antimicrobial resistance. In an analysis of the websites of seven private companies offering online video consultations with GPs, there was no mention of appropriate antibiotic use or antibiotic stewardship on any of them, despite four of the websites stating they would prescribe such treatments; one of these even appeared to use easy accessibility of antibiotics as a marketing strategy. However, the team did add that there are opportunities for such a system to improve health literacy on issues such as antimicrobial resistance.

Patient Education
“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’,” explained lead author Dr Benedict Hayhoe, Imperial College London. “However, 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.”

New Pressures
The authors also fear that any relief on pressures in primary care through video consultations may be counterbalanced by new pressures caused by defensive practices and supply-induced demand. These are areas that need to be studied further before this method can be considered a viable alternative to face-to-face consultations, according to the research.

Collaborative Opportunities
Nevertheless, the study does include collaborative opportunities between the NHS and private companies to help achieve the goal of increased online access to primary healthcare.

James Coker, Reporter