Medication prescribing in face-to-face versus telehealth consultations during the COVID-19 pandemic in Australian general practice: a retrospective observational study

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Figure 1. Participant selection flow chart, April–December 2020. ^aIndicates prescriptions not associated (linked) with the selected Medicare Benefit Scheme items for standard, chronic disease management, and mental health-related consultations. MH = mental health.
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Figure 2. Risk-adjusted rate of prescribing at least one medication by month of GP consultation, April–December 2020. Risk-adjustment included patient level variables (age, sex, socioeconomic status, patient status, and the remoteness index)

Table 1. Baseline characteristics of consultations, April–December 2020

Variables, n (%)	Face to face( n = 8 303 233)	Telehealth( n = 5 304 983)	Overall (n = 13 608 216)
Sex, Female	4 684 918 (56.4)	3 324 348 (62.7)	8 009 266 (58.9)
Age group , years
<40	3 342 444 (40.3)	2 086 727 (39.3)	5 429 171 (39.9)
40–59	2 063 824 (24.9)	1 420 669 (26.8)	3 484 493 (25.6)
60–74	1 714 115 (20.6)	1 030 080 (19.4)	2 744 195 (20.2)
≥75	1 182 850 (14.2)	767 507 (14.5)	1 950 357 (14.3)
Socioeconomic status/IRSAD ^a
1 (most disadvantaged)	932 407 (11.3)	429 285 (8.1)	1 361 692 (10.0)
2	1 089 856 (13.2)	559 819 (10.6)	1 649 675 (12.2)
3	1 101 025 (13.3)	795 165 (15.0)	1 896 190 (14.0)
4	1 933 384 (23.3)	1 292 530 (24.4)	3 225 914 (23.8)
5 (most advantaged)	3 227 349 (39.0)	2 216 393 (41.7)	5 443 742 (40.1)
Remoteness ^a
Major cities	7 417 738 (89.5)	4 695 032 (88.7)	12 112 770 (89.2)
Inner regional	793 798 (9.6)	560 362 (10.6)	1 354 160 (10.0)
Outer regional or remote or very remote	73 194 (0.9)	38 290 (0.7)	111 484 (0.8)
Patient status
Active	7 646 925 (92.1)	5 116 207 (96.4)	12 763 132 (93.8)
Non-active	656 308 (7.9)	188 776 (3.6)	845 084 (6.2)
State
Victoria	4 470 203 (53.8)	3 764 927 (71.0)	8 235 130 (60.5)
NSW	3 833 030 (46.2)	1 540 056 (29.0)	5 373 086 (39.5)

^a≈0.2% missing data. IRSAD = Index of Relative Socioeconomic Advantage and Disadvantage. NSW = New South Wales.

Table 2. Difference in medication prescribing between face-to-face and telehealth consultations, April–December 2020

Consultation type		Number of consultations with at least one medication prescribed, n (%)	Total consultations, n	Face to face versus telehealth
Consultation type			Total consultations, n	Difference, %	OR (95% CI)^a
Victoria	Face to face	1 807 097 (40.4)	4 470 203	5.4	1.28 (1.270 to 1.281)
Victoria	Telehealth	1 319 473 (35.0)	3 764 927	5.4	1.28 (1.270 to 1.281)
NSW	Face to face	1 457 651 (38.0)	3 833 030	9.9	1.62 (1.619 to 1.630)
NSW	Telehealth	432 405 (28.1)	1 540 056	9.9	1.62 (1.619 to 1.630)
Overall	Face to face	3 264 748 (39.3)	8 303 233	6.3	1.38 (1.379 to 1.381)
Overall	Telehealth	1 751 878 (33.0)	5 304 983	6.3	1.38 (1.379 to 1.381)

^aAdjusted for age, sex, socioeconomic status, patient status, remoteness, primary health network, and the state of the practice. NSW = New South Wales.

Table 3. Difference in first-time medication prescribing between face-to-face and telehealth consultations, April–December 2020

Consultation type		Number of consultations with a first-time prescription, n (%)	Total consultations, n	Face to face versus telehealth
Consultation type			Total consultations, n	Difference, %	OR (95% CI)^a
Victoria	Face to face	830 677 (18.6)	4 470 203	7.9	1.93 (1.929 to 1.940)
Victoria	Telehealth	401 378 (10.7)	3 764 927	7.9	1.93 (1.929 to 1.940)
NSW	Face to face	689 724 (18.0)	3 833 030	9.2	2.33 (2.320 to 2.350)
NSW	Telehealth	135 766 (8.8)	1 540 056	9.2	2.33 (2.320 to 2.350)
Overall	Face to face	1 520 401 (18.3)	8 303 233	8.2	2.03 (2.020 to 2.031)
Overall	Telehealth	537 144 (10.1)	5 304 983	8.2	2.03 (2.020 to 2.031)

^aAdjusted for age, sex, socioeconomic status, patient status, remoteness, PHN, and the state of the practice. NSW = New South Wales.

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