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In a study that analyzed more than 22 million urgent care visits from 2018 to 2022, researchers assessed prescribing practices across several drug categories with the aim to shed light on opportunities for tailored stewardship programs. Among the total visits across all age groups, antibiotics were prescribed in 12.4% of visits, glucocorticoids in 9.1% of visits, and opioids in 1.3% of visits, as published in Annals of Internal Medicine. However, the authors estimate a substantial proportion of the prescriptions written in urgent care would be considered “generally inappropriate” or “never appropriate” for the presenting conditions. For antibiotic prescribing, appropriateness was based on established consensus schemes. For glucocorticoid prescribing, appropriateness was based on previous studies, and for opioids, prescribing was deemed “generally inappropriate” for most diagnoses.
Antibiotics Prescribed By Percentage of Visits
- Urinary tract infection visits: 63.9% (“always appropriate”)
- Upper respiratory visits: 58.2% (“always appropriate”)
- Genitourinary signs and symptoms visits: 45.7% (“never appropriate”)
- Otitis media visits: 30.6% (“never appropriate”)
- Acute bronchitis visits: 15.0% (“never appropriate”)
Glucocorticoids Prescribed By Percentage of Visits
- Acute bronchitis visits: 40.8% (“generally inappropriate”)
- Sinusitis visits: 23.9% (“generally inappropriate”)
- Upper respiratory visits: 11.9% (“generally inappropriate”)
Opioids Prescribed By Percentage of Visits
- Abdominal pain and digestive symptoms visits: 6.3% (“generally inappropriate”)
- Musculoskeletal pain (non-back) visits: 4.6% (“generally inappropriate”)
- Sprains and strains visits: 4.0% (“generally inappropriate”)
Looking deeper: “This study is important as it adds to the paucity of data on urgent care medication prescribing in key areas including antibiotics, glucocorticoids, and opioids,” says Lindsey E. Fish, MD, FCUCM, Editor in Chief of JUCM. “While there are some significant strengths and limitations to the study, it reinforces the need to understand the current urgent care prescribing state in order to develop effective interventions to improve patient care.”
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