The following is a summary of “Trends in low-value GP care during the COVID-19 pandemic: a retrospective cohort study,” published in the 28 February 2024 issue of Primary Care by Müskens, et al.
During the COVID-19 pandemic, patients avoided visiting their general practitioners (GPs), leading to delayed or forgone medical care. The situation also raised concerns about the provision of low-value care, which offers no net benefit to patients. For a study, researchers sought to assess the impact of COVID-19 restrictions on three types of low-value GP care: imaging for back or knee problems, antibiotics for otitis media acuta (OMA), and repeated opioid prescriptions without a prior GP visit.
They conducted a retrospective cohort study using registration data from GPs within an academic GP network from 2017 to 2022. The COVID-19 period spanned from April 2020 to December 2021, with pre-and post-restriction periods before and after this period. Three clinical practices were selected based on their perceived prevalence and relevance in practice. Multilevel Poisson regression models were utilized to examine changes in the incidence rates (IR) of registered episodes and episodes receiving low-value treatment.
During the COVID-19 restrictions period, the IRs of all three types of GP care episodes decreased significantly: back or knee pain episodes by 12%, OMA episodes by 54%, and opioid prescription rates by 13%. Although the IR of OMA episodes remained significantly lower (22%) during the post-restrictions period, the provision of low-value care also changed. The IR of imaging for back or knee pain and low-value prescription of antibiotics for OMA decreased significantly during the COVID-19 restrictions period (by 21% and 78%, respectively), with only the low-value prescription rate of antibiotics for OMA remaining significantly lower (by 63%) during the post-restrictions period. However, the IR of inappropriately repeated opioid prescriptions remained unchanged over all three periods.
The study highlighted that COVID-19 restrictions affected both the rate of episodes and the rate of low-value care provision, with variations depending on the type of low-value care. It suggested that tailored interventions are needed to de-implement low-value care, indicating that a single disruption or intervention may not be sufficient.
Reference: bmcprimcare.biomedcentral.com/articles/10.1186/s12875-024-02306-7