Document Type : Original Article
Authors
1
Research on Healthcare Performance (RESHAPE), INSERM U1290, Université Claude Bernard Lyon 1, Lyon, France
2
Collège universitaire de Médecine Générale, Université Lyon 1, Villeurbanne, France
3
Service Pharmacie, Hôpital des Charpennes, Hospices Civils de Lyon, Villeurbanne, France
4
Pôle Territorial Santé Publique, Hôpitaux Champagne Sud, Troyes, France
5
Faculté de Médecine, Université de Reims Champagne Ardennes, Reims, France
6
Centre for Research in Epidemiology and Statistics (CRESS), Université Paris Cite and Université Sorbonne Paris Nord, Inserm, INRAE, Paris, France
7
Department of General Practice, Université Paris Cité, Paris, France
8
Hospices Civils de Lyon, Service des Données de Santé, Lyon, France
Abstract
Background
Teleconsultation services grew significantly in France during the COVID-19 pandemic. Reimbursed teleconsultations increased by a hundredfold between 2019 and 2021, establishing it as an emerging healthcare delivery modality. However, medication dispensing patterns following teleconsultations remain largely unexplored. This study aimed to characterize post-teleconsultation medication dispensing patterns between 2021 and 2023.
Methods
A retrospective cohort study was conducted using data from the French health database. The study included all teleconsultations conducted that resulted in at least one medication dispensing event (TLCs) between January 1, 2021, and June 30, 2023. We described patient demographics, prescriber characteristics, and dispensed medication.
Results
During the study period, 11 202 364 TLCs (34.3%) out of 33 853 911 resulted in medication dispensing. Among these 11 202 364 TLCs, the patient population predominantly comprised females (64.4%), individuals without long-term medical conditions (86.4%), with a mean age of 42.2 years (SD ± 20.8). Teleconsultations were mainly conducted by liberals’ physicians (86.8%) and health centre-employed practitioners (12.1%). The use of teleconsultation platforms increased fivefold between the first semesters 2021 (4.2%) and 2023 (28.2%). Teleconsultations resulted in medications targeting the nervous system (53.1%), digestive system (28.3%), and respiratory system (21.8%). Two contexts of dispensing emerged: dispensing with chronic indication (42.8% of TLCs) characterized by a long median time and several dispensing, and dispensing with an acute indication (55.6%), characterized by single dispensing with a 0-1 day between teleconsultation and dispensing.
Conclusion
One third of the teleconsultations resulted in medication dispensing, mainly for young, urban patients with good access to care, in contrast to the objective as described in the French Law. Dispensing patterns revealed two distinct modalities, acute symptomatic and chronic disease management. Certain classes of drugs dispensed (antibiotics, opioids, benzodiazepines) may raise questions about appropriate dispensing practices in teleconsultations.
Keywords
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