Urgent care clinics are pushing pain pills that do little to treat conditions, new study finds
Researchers said Tuesday that a substantial number of antibiotic, glucocorticoid, and opioid prescriptions were filled despite being deemed inappropriate given the patients' diagnoses — potentially resulting in harm.
Antibiotics are commonly used to treat infections, glucocorticoids are steroids that can treat arthritis and asthma, and opioids are prescribed to treat pain. America's opioid epidemic, which has led to thousands of deaths, has been tied to an increase in painkiller prescriptions.
"Previous studies had shown that patients continue to receive antibiotics for diagnoses where they may not be indicated, such as for a viral respiratory infection, especially in urgent care settings,' Dr. Shirley Cohen-Mekelburg, an assistant professor at the University of Michigan Medical School, said in a statement. 'Our findings reveal that this trend of inappropriate prescribing includes other classes of drugs — including glucocorticoids — and a variety of conditions.'
The reason for these findings, they suggest, is tied to the knowledge of clinic doctors, demand from patients, and a lack of an information system to support the clinicians' decisions.
"I think that opioids are generally overprescribed when the medical staff under appreciates the risks," Dr. Andrew Kolodny, medical director of the Opioid Policy Research Collaborative at Brandeis University, told MedPage Today. "If the clinicians understood that their prescriptions were more likely to harm patients than help them, I think they'd prescribe more cautiously."
Kolodny, who was not involved in the study, said that while opioid prescribing in general has been improving, data shows that 'we've got a long way to go when it comes to urgent care settings.'
There are currently more than 14,000 urgent care centers located across the U.S.. They exist to bridge the gap between primary and emergency care, the Urgent Care Association notes. Many of these clinics have their own pharmacies and accept most insurance plans, according to the The American Journal of Managed Care.
Using data from more than 22 million urgent care visits between 2018 to 2022, the researchers found that the visits resulted in nearly 2.8 million antibiotic prescriptions, more than 2 million prescriptions of glucocorticoids, and 299,210 opioid prescriptions. Of those, the fractions of the cases were categorized as 'never appropriate' or 'generally inappropriate,' with drugs handed out for health conditions the drugs were not meant to treat.
Some 46 percent of patients with urinary symptoms received inappropriate prescriptions of antibiotics and 41 percent of patients with bronchitis received inappropriate prescriptions of glucocorticoids.
The cases were also related to middle-ear infections, sinus infections, non-back musculoskeletal pain, abdominal pain, digestive symptoms, and sprains and strains.
It was not immediately clear what the effects of these prescriptions were, or if they had resulted in any harm.
The researchers suggest that drug stewardship programs to optimize use of the drugs, using electronic health records, and further medication education could have an effect.
'Reducing inappropriate prescribing of antibiotics, glucocorticoids and opioids will require a multifaceted approach,' Cohen-Mekelburg said. 'Providers at urgent centers would benefit from greater support and feedback in making these decisions.'
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