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Remote Cardiology Visits Tied to Less Prescribing, Diagnostic Testing

TUESDAY, April 6, 2021 -- Remote ambulatory cardiovascular visits during the COVID-19 pandemic are associated with a decrease in the ordering frequency of both diagnostic testing and medications when compared with pre-COVID-19 in-person visits, according to a study published online April 5 in JAMA Network Open.

Neal Yuan, M.D., from the Cedars-Sinai Medical Center in Los Angeles, and colleagues assessed whether the transition to remote visits is associated with disparities in patient use of care, diagnostic test ordering, and medication prescribing among remote and in-person cardiovascular care. Disparities in the COVID-19 era (April 1 to Dec. 30, 2020) were compared to those in the same time period in 2019. The analysis included 87,182 pre-COVID-19 in-person, 74,498 COVID-19-era in-person, 4,720 COVID-19-era video, and 10,381 COVID-19-era telephone visits.

The researchers found that patients using COVID-19-era remote options for ambulatory cardiology visits were more likely to be Asian, Black, or Hispanic individuals, have private insurance, and have cardiovascular comorbidities. During video and telephone visits, clinicians had lower odds of ordering any medication (COVID-19-era in-person: odds ratio [OR], 0.62; COVID-19-era video: OR, 0.22; COVID-19-era telephone: OR, 0.14) or tests, such as electrocardiograms (COVID-19-era in-person: OR, 0.60; COVID-19-era video: OR, 0.03; COVID-19-era telephone: OR, 0.02) or echocardiograms (COVID-19-era in-person: OR, 1.21; COVID-19-era video: OR, 0.47; COVID-19-era telephone: OR, 0.28) compared with pre-COVID-19 in-person visits, after adjusting for patient and visit characteristics.

"Remote cardiology clinic visits were used more often by certain traditionally underserved patient groups but were also associated with less frequent testing and prescribing," the authors write.

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