Dr Samantha Webster, vet at Joii Pet Care
Remote Prescribing Research Prompts Vet-AI To Call For Renewed Industry-wide Approach
Leading telemedicine firm, Vet-AI, is calling for remote prescribing to be permitted for video consultations across the veterinary industry after research revealed treatment through the height of the Covid-19 lockdown period to be successful.
Vet-AI, which offers video veterinary consultations via its Joii Pet Care app, analysed records from all consultations across the height of the pandemic, between 1 April and 31 October 2020. It has this week published a paper on RCVS Knowledge’s Journal Veterinary Evidence, sharing in-depth details to provide evidence and highlight the positive impact that remote prescribing, without physical examination in person, has on animal health and welfare.
Vet-AI’s research found there to be a low prescribing rate, including a low antibiotic prescribing rate; and treatments were efficacious and no harm was caused by prescribing remotely.
In the seven-month timeframe, Joii Pet Care’s RCVS-registered vets conducted 21,383 veterinary video consultations: 78.1% of which were for dogs and 21.9% for cats. Of the total vet-led video consultations completed, 3,541 had medicines prescribed during the consultation. Some consultations required more than one prescription, which meant a total of 4,282 POM-V medications were prescribed. Of those, just 0.87% reported a mild adverse effect.
Antibiotics were prescribed in 5.9% of all consultations, 99.3% of which was first line. Follow-up on prescribing was available in 67.7% of cases and 89.4% of all known treatment outcomes were complete or had an expected response to treatment. Skin problems were the most common body system/disease category seen and prescribed for.
The remaining 17,482 consultations, which did not require a prescription medicine, had resolutions assigned. This included 959 referrals to an emergency in-person veterinarian visit; 4,852 recommendations to visit a vet in-person; 4,216 alternative products recommended, 6,421 follow-up consultations with the remote veterinary team; 219 remote laboratory tests.
Details investigated in the analysis included patient signalment, body system condition/disease categories managed, referrals into practice, medication classes prescribed and outcomes following POM-V medications. Records of adverse events and antimicrobial prescribing were also reviewed.
The RCVS allowed remote prescribing from March-November 2020* to help the industry deal with demand at a time when practices closed due to Covid-19 restrictions. It then put in place a requirement to provide in-person care to prescribe remotely from November 2020, which was initially allowed until December 2021 in light of ‘additional pressures on practices’ but was removed completely in March this year.** March this year.
Vet Dr Samantha Webster, of Joii Pet Care, said: “Given the clear evidence outlined in this report, we believe the future of veterinary medicine should include remote consultations with remote prescribing where appropriate and regulated. We invite the RCVS and other veterinary governing bodies to consider that there is a place for prescribing remotely on an ongoing basis for certain cases under certain conditions, such as a secure video and audio link with clinical record keeping and pharmacovigilance practice. A blanket ban is not appropriate with the advance of modern technology.
“Bold steps have been taken in human health, incorporating modern technologies to support both GPs and patients, to great success. Our industry could use these learnings to help reduce the current strain and demands on vets across the country where mental health is already a key issue due to increased pressures, under resourcing, and compassion fatigue.
“We feel it’s important to take this approach to reach as many owners and provide professional advice and appropriate treatment on pet health so that those animals that do not necessarily currently receive veterinary care do so, and to bridge the gap wanted by clients.”
The research paper outlines how Joii Pet Care clients are provided with an in-app treatment plan at the end of every video consultation. The company keeps clinical records for every consultation, which are provided to a client’s local registered veterinary practice when appropriate.
When prescribing POM-V, clinical history from every patient’s physical veterinary practice was sought, with owner permission, and chronic medication prescriptions were refused if a full and accurate clinical history could not be obtained. In emergency situations where acute medication was needed to be prescribed for animal welfare reasons, prescribing occurred and a history was sought, or several attempts made to obtain the history, from the registered veterinary practice (following guidance set out in the RCVS code of conduct 5.7). When a patient treated with POM-V remotely was referred into a physical veterinary practice, clinical history was forwarded to that practice, with owner permission.
Dr Webster added: “We’re asking that consideration is given to reinstate remote prescribing across the industry and that we work together as an industry to collectively make positive change. Not only does it support the whole profession by triaging for the more complex cases and treating minor ailments - therefore reducing impact on physical practices - but it also offers more options for pet owners; which in turn improves animal health and welfare.
“We’re committed to playing our role in the veterinary industry to make sure that the very best clinical advice is available throughout the UK, at all times of day. It’s crucial that telemedicine and in-person practice works seamlessly to cater for the growing demands on our profession.”
Vet-AI is keen to hear from veterinary professionals on this subject and welcomes feedback on how best to work collaboratively across the sector to achieve change. Email firstname.lastname@example.org to share your views on this proposal.
The full research paper is available to read on Veterinary Evidence.
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