Sex differences among users of NSAIDs and opioids during COVID-19 Pandemic.
COVID-19 pandemic
NSIADs
Opioids
Sex difference
Utilization
Journal
International journal of clinical pharmacy
ISSN: 2210-7711
Titre abrégé: Int J Clin Pharm
Pays: Netherlands
ID NLM: 101554912
Informations de publication
Date de publication:
Feb 2023
Feb 2023
Historique:
received:
17
03
2022
accepted:
22
07
2022
pubmed:
18
10
2022
medline:
25
2
2023
entrez:
17
10
2022
Statut:
ppublish
Résumé
Sex-based inequalities in healthcare have been exposed and amplified during the COVID-19 pandemic. However, few studies have reported sex differences in medication utilization and no studies have examined sex differences in prescribed non-steroidal anti-inflammatory drugs (NSAIDs) and opioids utilization. To compare the utilization patterns of prescribed NSAIDs and opioids between males and females in Manitoba, Canada during the COVID-19 pandemic. A cohort of incident and prevalent users of prescribed NSAIDs and opioids was created. Interrupted times series analysis using autoregressive models were used to evaluate the quarterly change in the prevalent and incident users before and after COVID-19 restrictions were applied (first quarter of 2020). COVID-19 restrictions were associated with a significant decrease in the utilization of prescribed NSAIDs and opioids in all users, followed by a revert to the pre-pandemic trends. Among female prevalent and incident NSAIDs users, there was a significant change in trend after COVID-19 restrictions were introduced (β In this study, a significant sharp decline in the use of prescribed NSAIDs and opioids was shown in both sexes at the onset of the pandemic. However, a significant upward trend is observed in female NSAIDs users as restrictions began to be lifted.
Sections du résumé
BACKGROUND
BACKGROUND
Sex-based inequalities in healthcare have been exposed and amplified during the COVID-19 pandemic. However, few studies have reported sex differences in medication utilization and no studies have examined sex differences in prescribed non-steroidal anti-inflammatory drugs (NSAIDs) and opioids utilization.
AIM
OBJECTIVE
To compare the utilization patterns of prescribed NSAIDs and opioids between males and females in Manitoba, Canada during the COVID-19 pandemic.
METHOD
METHODS
A cohort of incident and prevalent users of prescribed NSAIDs and opioids was created. Interrupted times series analysis using autoregressive models were used to evaluate the quarterly change in the prevalent and incident users before and after COVID-19 restrictions were applied (first quarter of 2020).
RESULTS
RESULTS
COVID-19 restrictions were associated with a significant decrease in the utilization of prescribed NSAIDs and opioids in all users, followed by a revert to the pre-pandemic trends. Among female prevalent and incident NSAIDs users, there was a significant change in trend after COVID-19 restrictions were introduced (β
CONCLUSION
CONCLUSIONS
In this study, a significant sharp decline in the use of prescribed NSAIDs and opioids was shown in both sexes at the onset of the pandemic. However, a significant upward trend is observed in female NSAIDs users as restrictions began to be lifted.
Identifiants
pubmed: 36253662
doi: 10.1007/s11096-022-01463-y
pii: 10.1007/s11096-022-01463-y
pmc: PMC9575648
doi:
Substances chimiques
Analgesics, Opioid
0
Anti-Inflammatory Agents, Non-Steroidal
0
Types de publication
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Pagination
233-239Informations de copyright
© 2022. The Author(s), under exclusive licence to Springer Nature Switzerland AG.
Références
WHO Coronavirus (COVID-19) dashboard with vaccination data. https://covid19.who.int . Accessed 25 Feb 2022.
The Covid-19 effects on societies and economies|News| wellcome. https://wellcome.org/news/equality-global-poverty-how-covid-19-affecting-societies-and-economies . Accessed 1 Feb 2022.
Polisena J, Ospina M, Sanni O, et al. Public health measures to reduce the risk of SARS-CoV-2 transmission in Canada during the early days of the COVID-19 pandemic: a scoping review. BMJ Open. 2021;11:e046177.
doi: 10.1136/bmjopen-2020-046177
pubmed: 33687956
Manitoba declares state of emergency amid COVID-19 pandemic | CTV News. https://winnipeg.ctvnews.ca/manitoba-declares-state-of-emergency-amid-covid-19-pandemic-1.4861333 . Accessed 1 Feb 2021.
Wiseman SM, Trafford CR, Sutherland JM. Surgical wait list management in Canada during a pandemic: many challenges ahead. Can J Surg. 2020;63(3):E226–8.
doi: 10.1503/cjs.006620
pubmed: 32386471
pmcid: 7829000
Doctors Manitoba | Doctors and patients support permanent virtual care options. https://doctorsmanitoba.ca/news/doctors-and-patients-support-permanent-virtual-care-options . Accessed 1 Feb 2021.
Mauvais-Jarvis F, Merz NB, Barnes PJ, et al. Sex and gender: modifiers of health, disease, and medicine. Lancet. 2020;396:565–82.
doi: 10.1016/S0140-6736(20)31561-0
pubmed: 32828189
pmcid: 7440877
Barnabe C, Bessette L, Flanagan C, et al. Sex differences in pain scores and localization in inflammatory arthritis: a systematic review and metaanalysis. J Rheumatol. 2012;39:13.
doi: 10.3899/jrheum.111393
Bartley EJ, Fillingim RB. Sex differences in pain: a brief review of clinical and experimental findings. BJA Br J Anaesth. 2013;111:52.
doi: 10.1093/bja/aet127
pubmed: 23794645
Robinson ME, Wise EA, Riley JL, et al. Sex differences in clinical pain: a multisample study. J Clin Psychol Med Settings. 1998;5:413–24.
doi: 10.1023/A:1026282210848
Sharp JL, Pearson T, Smith MA. Sex differences in opioid receptor mediated effects: role of androgens. Neurosci Biobehav Rev. 2022;134:104522.
doi: 10.1016/j.neubiorev.2022.104522
pubmed: 34995646
Sorge RE, Totsch SK. Sex differences in pain. J Neurosci Res. 2017;95:1271–81.
doi: 10.1002/jnr.23841
pubmed: 27452349
Pisanu C, Franconi F, Gessa GL, et al. Sex differences in the response to opioids for pain relief: a systematic review and meta-analysis. Pharmacol Res. 2019;148:104447.
doi: 10.1016/j.phrs.2019.104447
pubmed: 31499196
Dassieu L, Pagé MG, Lacasse A, et al. Chronic pain experience and health inequities during the COVID-19 pandemic in Canada: qualitative findings from the chronic pain & COVID-19 pan-Canadian study. Int J Equity Health. 2021;20:1–13.
doi: 10.1186/s12939-021-01496-1
Chatkoff DK, Leonard MT, Najdi RR, et al. A brief survey of the COVID-19 pandemic’s impact on the chronic pain experience. Pain Manag Nurs. 2022;23:3–8. https://doi.org/10.1016/j.pmn.2021.10.003 .
doi: 10.1016/j.pmn.2021.10.003
pubmed: 34772607
Lacasse A, Pagé MG, Dassieu L, et al. Impact of the COVID-19 pandemic on the pharmacological, physical, and psychological treatments of pain: Findings from the Chronic Pain & COVID-19 Pan-Canadian Study. Pain Reports. 2021;6:e891. https://doi.org/10.1097/PR9.0000000000000891 .
doi: 10.1097/PR9.0000000000000891
pubmed: 33598594
pmcid: 7880148
The sex, gender and COVID-19 project|global health 50/50. https://globalhealth5050.org/the-sex-gender-and-covid-19-project . Accessed 1 Feb 2021.
Bigalke JA, Greenlund IM, Carter JR. Sex differences in self-report anxiety and sleep quality during COVID-19 stay-at-home orders. Biol Sex Differ. 2020;11:1–11.
doi: 10.1186/s13293-020-00333-4
Henderson M, Fitzsimons E, Ploubidis G, et al. Mental health during lockdown: evidence from four generations Initial findings from the COVID-19 survey in five national longitudinal studies find out more.
Yu C, Boone C, Askarian-Monavvari R, et al. Trends in pharmacotherapy for anxiety and depression during COVID-19: a north york area pilot study. Univ Toronto Med J. 2021;98:41–6.
Mamun AA, Saatchi A, Xie M, et al. Community antibiotic use at the population level during the SARS-CoV-2 pandemic in British Columbia Canada. Open Forum Infect Dis. 2021;8(6):ofab185.
doi: 10.1093/ofid/ofab185
pubmed: 34183981
pmcid: 8083279
Bovill JG. Mechanisms of actions of opioids and non-steroidal anti-inflammatory drugs. Eur J Anaesthesiol Suppl. 1997;15(5):9–15.
doi: 10.1097/00003643-199705001-00003
pubmed: 9202932
Schopflocher D, Taenzer P, Jovey R. The prevalence of chronic pain in Canada. Pain Res Manag J Can Pain Soc. 2011;16:445.
doi: 10.1155/2011/876306
Serdarevic M, Striley CW, Cottler LB. Gender differences in prescription opioid use. Curr Opin Psychiatry. 2017;30:238.
doi: 10.1097/YCO.0000000000000337
pubmed: 28426545
pmcid: 5675036
Term: Incidence / Incidence Rate: Manitoba Centre for Health Policy (MCHP). http://mchp-appserv.cpe.umanitoba.ca/viewDefinition.php?definitionID=102877 (2015). Accessed 30 May 2022.
Term: Prevalence:Manitoba Centre for Health Policy (MCHP). http://mchp-appserv.cpe.umanitoba.ca/viewDefinition.php?definitionID=103393 (2013). Accessed 30 May 2022.
Concept: prevalence and incidence: Manitoba centre for health policy (MCHP). http://mchp-appserv.cpe.umanitoba.ca/viewConcept.php?conceptID=1036 (2002). Accessed 30 May 2022.
Aboulatta L, Kowalec K, Delaney J, et al. Trends of COVID-19 incidence in Manitoba and public health measures: March 2020 to February 2022. BMC Res Notes. 2022;15:162.
doi: 10.1186/s13104-022-06049-5
pubmed: 35538498
pmcid: 9088149
Downs CG, Varisco TJ, Bapat SS, et al. Impact of COVID-19 related policy changes on filling of opioid and benzodiazepine medications. Res Soc Adm Pharm. 2021;17:2005–8.
doi: 10.1016/j.sapharm.2020.06.003
Nikolaus O, Palmer A, Seoudi N. The effect of SARS-CoV-2 on the prescribing of antimicrobials and analgesics by NHS general dental practitioners in England. Br Dent J. 2021;2021:1–6.
Licciardone JC. Impact of COVID-19 on utilization of nonpharmacological and pharmacological treatments for chronic low back pain and clinical outcomes. J Osteopath Med. 2021;121(7):625–33.
doi: 10.1515/jom-2020-0334
pubmed: 33770828
Henschke N, Kamper SJ, Maher CG. The epidemiology and economic consequences of pain. Mayo Clin Proc. 2015;90(1):139–47.
doi: 10.1016/j.mayocp.2014.09.010
pubmed: 25572198
Manitoba introduces new ways to access virtual health care | CTV News. https://winnipeg.ctvnews.ca/manitoba-introduces-new-ways-to-access-virtual-health-care-1.4912110 . Accessed 1 Feb 2020.
MHSAL medication restrictions March19, 2020. https://www.gov.mb.ca/health/pharmacare/profdocs/covid19_30days.pdf . Accessed 1 Feb 2021.
Day M. Covid-19: ibuprofen should not be used for managing symptoms, say doctors and scientists. BMJ. 2020;17(368): m1086.
doi: 10.1136/bmj.m1086
Expert reaction to reports that the French Health Minister recommended use of paracetamol for fever from COVID-19 rather than ibuprofen or cortisone | science media centre: https://www.sciencemediacentre.org/expert-reaction-to-reports-that-the-french-health-minister-recommended-use-of-paracetamol-for-fever-from-covid-19-rather-than-ibuprofen-or-cortisone . Accessed 1 Feb 2020.
Wong AYS, MacKenna B, Morton CE, et al. Use of non-steroidal anti-inflammatory drugs and risk of death from COVID-19: an OpenSAFELY cohort analysis based on two cohorts. Ann Rheum Dis. 2021;80(7):943–51.
doi: 10.1136/annrheumdis-2020-219517
pubmed: 33478953
Abu Esba LC, Alqahtani RA, Thomas A, et al. Ibuprofen and NSAID use in COVID-19 infected patients is not associated with worse outcomes: a prospective cohort study. Infect Dis Ther. 2021;10(1):253–68.
doi: 10.1007/s40121-020-00363-w
pubmed: 33135113
Kragholm K, Gerds TA, Fosbø E, et al. Association between prescribed Ibuprofen and severe COVID-19 infection: a nationwide register-based cohort study. Clin Transl Sci. 2020;13(6):1103–7.
doi: 10.1111/cts.12904
pubmed: 32970921
pmcid: 7537121
Bruce E, Barlow-Pay F, Short R, et al. Prior routine use of non-steroidal anti-inflammatory drugs (NSAIDs) and important outcomes in hospitalised patients with COVID-19. J Clin Med. 2020;9(8):2586.
doi: 10.3390/jcm9082586
pubmed: 32785086
pmcid: 7465199
Lund LC, Kristensen KB, Reilev M, et al. Adverse outcomes and mortality in users of non-steroidal anti-inflammatory drugs who tested positive for SARS-CoV-2: a Danish nationwide cohort study. PLoS Med. 2020;17(9):e1003308.
doi: 10.1371/journal.pmed.1003308
pubmed: 32898149
pmcid: 7478808
Jeong HE, Lee H, Shin HJ, et al. Association between nonsteroidal antiinflammatory drug use and adverse clinical outcomes among adults hospitalized with Coronavirus 2019 in South Korea: a nationwide study. Clin Infect Dis. 2021;73(11):e4179–88.
doi: 10.1093/cid/ciaa1056
pubmed: 32717066
Chandan JS, Zemedikun DT, Thayakaran R, et al. Nonsteroidal antiinflammatory drugs and susceptibility to COVID-19. Arthritis Rheumatol. 2021;73(5):731–9.
doi: 10.1002/art.41593
pubmed: 33185016
pmcid: 8252419
Opioid Stewardship|ISMP Canada. https://www.ismp-canada.org/opioid_stewardship . Accessed 1 Feb 2022.
Tang YR, Yang WW, Wang YL, et al. Sex differences in the symptoms and psychological factors that influence quality of life in patients with irritable bowel syndrome. Eur J Gastroenterol Hepatol. 2012;24:702–7.
doi: 10.1097/MEG.0b013e328351b2c2
pubmed: 22382707
Turk DC, Okifuji A. Does sex make a difference in the prescription of treatments and the adaptation to chronic pain by cancer and non-cancer patients? Pain. 1999;82:139–48.
doi: 10.1016/S0304-3959(99)00041-X
pubmed: 10467919
Fosbøl EL, Gislason GH, Jacobsen S, et al. The pattern of use of non-steroidal anti-inflammatory drugs (NSAIDs) from 1997 to 2005: a nationwide study on 4.6 million people. Pharmacoepidemiol Drug Saf. 2008;17(8):822–33.
doi: 10.1002/pds.1592
pubmed: 18383428
Simoni-Wastila L. The use of abusable prescription drugs: the role of gender. J Womens Health Gend Based Med. 2000;9(3):289–97.
doi: 10.1089/152460900318470
pubmed: 10787224
Giurge LM, Whillans AV, Yemiscigil A. A multicountry perspective on gender differences in time use during COVID-19. Proc Natl Acad Sci U S A. 2021;118(12):e2018494118.
doi: 10.1073/pnas.2018494118
pubmed: 33798094
pmcid: 7999869
GH5050 summary findings on sex-disaggregation of data—Global Health 50/50. https://globalhealth5050.org/gh5050-summary-findings-on-sex-disaggregation-of-data . Accessed 1 Feb 2021.
Feldman S, Ammar W, Lo K, et al. Quantifying sex bias in clinical studies at scale with automated data extraction. JAMA Netw Open. 2019;2:e196700–e196700.
doi: 10.1001/jamanetworkopen.2019.6700
pubmed: 31268541
pmcid: 6613296