RT Journal Article
SR Electronic
T1 Remote versus in-person consultations for acute cystitis: antibiotic treatment and clinical outcomes, a retrospective cohort study
JF BJGP Open
JO BJGP Open
FD Royal College of General Practitioners
SP BJGPO.2025.0009
DO 10.3399/BJGPO.2025.0009
VO 9
IS 3
A1 Haugom, Lars Emil Aga
A1 Emberland, Knut Erik
A1 Rebnord, Ingrid Keilegavlen
A1 Rørtveit, Guri
A1 Eliassen, Knut Eirik Ringheim
YR 2025
UL http://bjgpopen.org/content/9/3/BJGPO.2025.0009.abstract
AB Background The COVID-19 pandemic brought a surge of remote consultations in Norwegian primary care with unknown implications for antibiotic treatment and outcomes of acute cystitis.Aim To examine whether there were differences in antibiotic treatment or repeat contacts for acute cystitis between remote and in-person consultations.Design & setting A retrospective cohort study was undertaken. For the 4-year period from 2018–2021, we linked individual registry data on all contacts for cystitis by women aged ≥16 years in general practice and out-of-hours (OOH) services in Norway with registry data on dispensed antibiotics.Method Index consultations for cystitis episodes were identified when there had been no urinary tract infection-related contacts or antibiotics dispensed at least 2 weeks before the consultation. We compared index remote versus index in-person consultations by antibiotic treatment within 3 days and repeat contacts within 14 days. Remote consultations were defined as consultations by text, telephone, or video.Results Remote consultations for acute cystitis increased markedly, from 0.5% of acute cystitis consultations in 2018 to 15.2% in 2021. Index remote consultations were associated with more second-line antibiotic treatment (adjusted relative risk [aRR] 1.04, 95% confidence interval [CI] = 1.02 to 1.06, P<0.001), and more repeat contacts (aRR 1.11, 95% CI = 1.09 to 1.12, P<0.001) than in-person consultations.Conclusion For acute cystitis, index remote consultations are associated with more second-line antibiotic treatment and more repeat contacts than in-person consultations. The unique time-period of the COVID-19 pandemic and the regular GP scheme in Norwegian primary care must be considered when interpreting these findings.