(B-086) Nervous System Medication Dispensing Patterns Following Teleconsultations in France from January 2021 to June 2023: A Repeated Cross-sectional Study Using the National Health Data System

Background: Nervous system (NS) medications carry inherent risks of misuse and diversion. Their dispensing requires adherence to prescription guidelines and rigorous patient monitoring. In France, teleconsultation (TLC) represents an emerging healthcare modality; however, its role in NS medication prescribing remains unevaluated.

Objectives: To characterize the patterns of NS medication dispensing following teleconsultations between 2021 and 2023.

Methods: A repeated cross-sectional study was conducted using data from the French National Health Data System (SNDS). The analysis encompassed all TLCs that resulted in at least one nervous system medication dispensing event. Variables analyzed included patient demographics (age, sex, deprivation index, healthcare accessibility), prescriber characteristics (preferred doctor, previously consulted professional), and dispensed medication profiles (drugs, median time interval between teleconsultation and dispensing, treatment initiations or renewals).

Results: During the study period, 5,953,235 TLCs out of 11,202,364 resulted in at least one NS medication dispensing event. The majority of TLCs led to the dispensing of medications in the following classes: analgesics (42.4%), antidepressants (16.7%), and benzodiazepines (13.5%). The median time between TLC and first dispensing ranged from 0 to 22 days according to ATC-3 classification, indicating either acute care TLC or follow-up appointments for chronic conditions. Regarding prescribers' characteristics, general practitioners and psychiatrists conducted 76.1% and 18.0% of TLCs resulting in NS medication dispensing, respectively. In terms of practice modality, private teleconsultation platforms (organizations employing healthcare professionals without an established patient base) accounted for 15.7% of TLCs leading to NS medication dispensing. This emerging practice modality increased fourfold between the first half of 2021 and the first half of 2023. Within these platform-based TLCs, the distribution of medication dispensing was as follows: analgesics (83.2%), benzodiazepines (6.9%), and antidepressants (6.1%).

Conclusions: Teleconsultation has established itself as a novel healthcare delivery modality, generating diverse NS medication management strategies. Certain contexts, such as the use of private platforms will need to be studied in greater detail in terms of appropriate prescribing practice for NS drugs.