Observational studyJournal of general internal medicine2020
Management of Urinary Tract Infections in Direct to Consumer Telemedicine.
Observational study in Journal of general internal medicine, 2020. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 18 papers, 1 of them a synthesis that pooled it.
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
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Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
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Who cites it
18 citing papers in PubMed, 1 synthesis or guideline pooled it.
- Telehealth in Urology: A Systematic Review of the Literature. How Much Can Telemedicine Be Useful During and After the COVID-19 Pandemic?European urology · 2020Pooled it
- Perceived Barriers to Care for Urinary Tract Infections in Emerging Adulthood.Journal of general internal medicine · 2026Trial
- E-Visit Usage Among a Population of Young Adults.The Permanente journal · 2026Article
- Article
- Indiscriminate antibiotic prescribing for nonspecific symptoms perpetuates gender-based healthcare inequities.AJOG global reports · 2025Article
- The comparative effectiveness of telehealth versus primary care and collection of urine cultures on outcome in urinary tract infection.Medicine · 2025Observational
- Antibiotic Prescribing by Digital Health Care Providers as Compared to Traditional Primary Health Care Providers: Cohort Study Using Register Data.Journal of medical Internet research · 2024Article
- Medical expenses and its determinants in female patients with urological disorder.Cost effectiveness and resource allocation : C/E · 2024Article
- Evaluating the association between expanded coverage of direct-to-consumer telemedicine and downstream utilization and quality of care for urinary tract infections and sinusitis.Health services research · 2023Article
- Home urinary tract infection testing: patient experience and satisfaction with polymerase chain reaction kit.International urogynecology journal · 2023Article
- Article
- Article
- Management of Acute Cystitis in the Era of COVID-19.Current bladder dysfunction reports · 2023Review
- Virtual Care and the Inverse Care Law: Implications for Policy, Practice, Research, Public and Patients.International journal of environmental research and public health · 2022Article
- Use of Direct-to-Consumer Telemedicine to Access Mental Health Services.Journal of general internal medicine · 2022Article
- [Digital innovation in medicine: the COVID-19 pandemic as an accelerator of "digital health"].Journal fur Urologie und Urogynakologie : Zeitschrift fur Urologie und Urogynakologie in Klinik und Praxis · 2021Article
- Diagnosis and Management of UTI in Primary Care Settings-A Qualitative Study to Inform a Diagnostic Quick Reference Tool for Women Under 65 Years.Antibiotics (Basel, Switzerland) · 2020Article
- Epidemiology and Treatment Barriers of Patients With Erectile Dysfunction Using an Online Prescription Platform: A Cross-Sectional Study.Sexual medicine · 2020Article
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Authors and funding
5 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundUrinary tract infections (UTI) are a common reason for seeking care via direct to consumer (DTC) telemedicine, yet patterns of care, including antibiotic prescribing, have not been reported.
objectiveTo describe management of UTI in a large nationwide DTC telemedicine platform.
designCross-sectional observational study.
participantsPatients seeking care for or diagnosed with UTI via DTC telemedicine between July 2016 and July 2018. MAIN MEASURES: Patient measures included age, sex, geographic region, satisfaction with care, and patient-reported call reason. High-risk patients were defined as males, patients over 65 years, or those diagnosed with pyelonephritis. Physician measures included specialty and geographic region. Antibiotic prescription was assessed overall and by antibiotic type. Variation in antibiotic prescriptions was assessed by patient and physician factors, including geographic region of both parties. KEY
resultsOf the 20,600 patients diagnosed with a UTI during the study period, 96% were female. Most (84%) stated their call reason was a UTI. Overall, 94% of UTI patients received an antibiotic; 56% got nitrofurantoin, 29% got trimethoprim-sulfamethoxazole, and 10% got a quinolone. Receipt of an antibiotic was associated with higher satisfaction with care (p < 0.001). While nitrofurantoin was the most common antibiotic for all physician regions, antibiotic type varied by physician region. Of the 6% of the study population defined as high risk, 69% received an antibiotic: 72% of males, 91% of women over 65, and 21% of patients diagnosed with pyelonephritis.
conclusionsManagement of UTI via DTC telemedicine appears to be appropriate for average-risk patients, and most are able to self-diagnose. Most patients received guideline-concordant care, but over half of high-risk patients received antibiotics. DTC telemedicine offers convenient, low-cost care that is generally appropriate. Efforts should be made to ensure high-risk patients get proper follow-up.
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