Background

In the UK, consultations for prescription medicines are available via private providers such as online pharmacies. However, these providers may have lower thresholds for prescribing certain drugs. This is a particular concern for antibiotics, given the increasing burden of antimicrobial resistance. Public preferences for consultations with online providers are unknown, hence the impact of increased availability of online consultations on antibiotic use and population health is unclear.

Objective

To conduct a discrete choice experiment survey to understand UK public preferences for seeking online consultations, and the factors that influence these preferences, in the context of having symptoms for which antibiotics may be appropriate.

Methods

In a survey conducted between July and August 2018, general population respondents completed 16 questions in which they chose a primary care consultation via either their local medical centre or an online provider. Consultations were described in terms of five attributes, including cost and similarity to traditional ‘face-to-face’ appointments. Choices were modelled using regression analysis.

Results

Respondents (n = 734) placed a high value on having a consultation via their local medical centre rather than an online provider, and a low value on consultations by phone or video. However, respondents characterised as ‘busy young professionals’ showed a lower strength of preference for traditional consultations, with a higher concern for convenience.

Conclusion

Before COVID-19, the UK public had limited appetite for consultations with online providers, or for consultations that were not face-to-face. Nevertheless, prescriptions from online providers should be monitored going forward, particularly for antibiotics, and in key patient groups.

中文翻译：

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在线服务提供者的医疗咨询偏好：英国离散选择实验的证据

背景

在英国，可通过在线药房等私营提供商来提供处方药咨询。但是，这些提供者开具某些药物的门槛可能较低。鉴于抗生素耐药性负担的增加，这是抗生素特别需要关注的问题。公众对与在线提供者进行咨询的偏好尚不清楚，因此不清楚在线咨询的可用性对抗生素使用和人群健康的影响。

客观的

进行离散选择实验调查，以了解英国公众对于寻求在线咨询的偏爱以及影响这些偏爱的因素（在出现可能适合抗生素的症状的情况下）。

方法

在2018年7月至2018年8月之间进行的一项调查中，普通人群回答了16个问题，他们通过当地医疗中心或在线提供商选择了初级保健咨询。协商是根据五个属性来描述的，包括成本和与传统“面对面”约会的相似性。使用回归分析对选择进行建模。

结果

受访者（n = 734）认为通过本地医疗中心而非在线提供商进行咨询的价值很高，而通过电话或视频进行咨询的价值较低。但是，以“忙碌的年轻专业人员”为特征的受访者对传统咨询的偏爱程度较低，对便利性的关注也更高。

结论

在COVID-19之前，英国公众对与在线提供商进行咨询或进行非面对面咨询的兴趣有限。但是，应继续监控在线提供商的处方，尤其是针对抗生素以及主要患者群体的处方。