# The impact of virtual care on drug prescribing practices: A scoping review

## TL;DR

This paper reviews global studies to see if virtual care changed how doctors prescribe medications during the pandemic.

## Contribution

It is the first scoping review to systematically examine global prescribing patterns in virtual versus in-person care post-COVID-19.

## Key findings

- Most studies found no significant difference in medication or antibiotic prescribing rates between virtual and in-person visits.
- Some weak evidence suggests virtual care may improve adherence to clinical guidelines.
- Findings are limited by a predominance of U.S.-based studies and methodological weaknesses.

## Abstract

Upon the emergence of COVID-19, virtual alternatives to in-person care developed quickly to meet the need of physicians to maintain medical distancing from patients. Virtual care has since become a mainstay in the landscape of primary care with many physicians providing both virtual and in-person visit options within their practice. However, due to its rapid development, questions have been raised regarding the quality of virtual care compared to its in-person alternative, particularly in terms of prescribing appropriateness. Thus, we examined whether global prescribing patterns differed between virtual and in-person physician visits following the onset of the COVID-19 pandemic. We conducted a scoping review of global literature with narrative synthesis to assess whether and how prescribing patterns differed between virtual and in-person care. This review revealed mixed findings, with the majority of studies reporting no significant difference in medication or antibiotic prescribing rates. Some weak evidence suggested virtual care may be associated with greater adherence to clinical guidelines. However, the predominance of United States based studies and methodological limitations precluded strong conclusions, particularly for the Canadian context. Our scoping review found no consensus in the global literature on how prescribing patterns differ between virtual and in-person care. The methodological weaknesses and limited generalizability of the existing body of evidence highlights the need for further high-quality research in a broader range of settings.

Virtual care became a prominent form of healthcare delivery following the COVID-19 pandemic. However, such quick implementation may have caused physicians to prescribe differently, and potentially inappropriately, during virtual care visits compared to in-person visits. Here, we investigated whether physician prescribing differs between virtual and in-person visits by conducting a scoping review of the global literature. Our review of global studies found mixed results, with most showing no major differences in prescribing between virtual and in-person care. Some global evidence suggested virtual care may be associated with more appropriate prescriptions. However, reported evidence was largely based out of the United States and many studies were subject to critical risk of bias. These findings indicate that further global research is required to reach consensus on the effects of virtual care on prescribing, particularly outside of the United States with methods less vulnerable to bias.