Drug utilization patterns before and during COVID-19 pandemic in Manitoba, Canada: A population-based study.


Journal

PloS one
ISSN: 1932-6203
Titre abrégé: PLoS One
Pays: United States
ID NLM: 101285081

Informations de publication

Date de publication:
2022
Historique:
received: 09 03 2022
accepted: 08 11 2022
entrez: 28 11 2022
pubmed: 29 11 2022
medline: 1 12 2022
Statut: epublish

Résumé

The COVID-19 pandemic has led the Canadian provincial governments to take unprecedented measures, including restrictions to healthcare services and pharmacists. Limited evidence exists on changes in prescription trends in Canada during the pandemic period. To examine the trend of prescription medications' utilization before and during COVID-19, among incident and prevalent users in the general population. We examined 18 major classes of medications. We used the administrative health databases from the province of Manitoba, Canada, to conduct a province-wide cross-sectional study. Incident and prevalent use was compared between two time periods; pre-COVID-19: July 2016-March 2020 and during COVID-19: April 2020-March 2021. Interrupted time series analysis using autoregressive models was used to quantify the change in level and slope in quarterly medication use among incident and prevalent users. The quarterly study population ranged from 1,353,485 to 1,411,630 Manitobans. The most common comorbidities were asthma (26.67%), hypertension (20.64%), and diabetes (8.31%). On average, the pandemic restrictions resulted in a 45.55% and 12.17% relative decline in the aggregated utilization of all drugs among both incident and prevalent users, respectively. Subclass analysis showed a 46.83%, 23.05%, and 30.98% relative drop among incident users of antibiotics, cardiovascular drugs and opioids use, respectively. We observed a significant slope increase during COVID-19 among the quarterly cardiovascular, antidiabetics, alpha-1 blockers, and statins incident users compared to the pre-COVID-19 period. We noted a significant decrease in level among NSAIDs, opioids, and antibiotic prevalent users, however, no significant changes in slope were observed. Our findings show a significant impact of COVID-19 measures on prescription trends in the general population. The observed decline among several medication classes was temporary. Further research is needed to monitor prescription trends and better understand if those changes were associated with increased health services and worsened outcomes.

Sections du résumé

BACKGROUND
The COVID-19 pandemic has led the Canadian provincial governments to take unprecedented measures, including restrictions to healthcare services and pharmacists. Limited evidence exists on changes in prescription trends in Canada during the pandemic period.
OBJECTIVES
To examine the trend of prescription medications' utilization before and during COVID-19, among incident and prevalent users in the general population. We examined 18 major classes of medications.
METHODS
We used the administrative health databases from the province of Manitoba, Canada, to conduct a province-wide cross-sectional study. Incident and prevalent use was compared between two time periods; pre-COVID-19: July 2016-March 2020 and during COVID-19: April 2020-March 2021. Interrupted time series analysis using autoregressive models was used to quantify the change in level and slope in quarterly medication use among incident and prevalent users.
RESULTS
The quarterly study population ranged from 1,353,485 to 1,411,630 Manitobans. The most common comorbidities were asthma (26.67%), hypertension (20.64%), and diabetes (8.31%). On average, the pandemic restrictions resulted in a 45.55% and 12.17% relative decline in the aggregated utilization of all drugs among both incident and prevalent users, respectively. Subclass analysis showed a 46.83%, 23.05%, and 30.98% relative drop among incident users of antibiotics, cardiovascular drugs and opioids use, respectively. We observed a significant slope increase during COVID-19 among the quarterly cardiovascular, antidiabetics, alpha-1 blockers, and statins incident users compared to the pre-COVID-19 period. We noted a significant decrease in level among NSAIDs, opioids, and antibiotic prevalent users, however, no significant changes in slope were observed.
CONCLUSION
Our findings show a significant impact of COVID-19 measures on prescription trends in the general population. The observed decline among several medication classes was temporary. Further research is needed to monitor prescription trends and better understand if those changes were associated with increased health services and worsened outcomes.

Identifiants

pubmed: 36441676
doi: 10.1371/journal.pone.0278072
pii: PONE-D-22-07068
pmc: PMC9704650
doi:

Substances chimiques

Analgesics, Opioid 0

Types de publication

Journal Article Research Support, Non-U.S. Gov't

Langues

eng

Sous-ensembles de citation

IM

Pagination

e0278072

Informations de copyright

Copyright: © 2022 Aboulatta et al. This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.

Déclaration de conflit d'intérêts

The authors have declared that no competing interests exist.

Références

Ann Pharmacother. 1998 Nov;32(11):1152-7
pubmed: 9825079
Am Heart J. 2021 Jan;231:1-5
pubmed: 33137309
J Am Geriatr Soc. 2021 Jul;69(7):1743-1745
pubmed: 33834488
J Clin Pharm Ther. 2002 Aug;27(4):299-309
pubmed: 12174032
BMC Res Notes. 2022 May 10;15(1):162
pubmed: 35538498
Infect Dis (Lond). 2021 Feb;53(2):142-144
pubmed: 33073645
Acad Pediatr. 2013 Nov-Dec;13(6 Suppl):S38-44
pubmed: 24268083
Trop Med Infect Dis. 2022 Feb 28;7(3):
pubmed: 35324584
Nat Rev Microbiol. 2021 Mar;19(3):141-154
pubmed: 33024307
Acta Biomed. 2020 Mar 19;91(1):157-160
pubmed: 32191675
Proc Natl Acad Sci U S A. 2020 Jun 2;117(22):11875-11877
pubmed: 32404416
Am J Gastroenterol. 2021 Aug 1;116(8):1738-1740
pubmed: 34587128
Viruses. 2021 Jul 07;13(7):
pubmed: 34372520
JAMA Netw Open. 2020 Nov 2;3(11):e2024984
pubmed: 33151319
Implement Sci. 2014 Jun 19;9:77
pubmed: 24943919
Clin Infect Dis. 2021 Aug 2;73(3):e652-e660
pubmed: 33373435
JAMA Netw Open. 2021 Aug 2;4(8):e2118441
pubmed: 34338794
Int J Epidemiol. 2017 Feb 1;46(1):348-355
pubmed: 27283160
JAMA. 2020 Jun 23;323(24):2524-2526
pubmed: 32463459
BMJ. 2015 Jun 09;350:h2750
pubmed: 26058820
Gut. 2021 Jan;70(1):76-84
pubmed: 32732368
PLoS One. 2021 Apr 1;16(4):e0249453
pubmed: 33793663
J Endocr Soc. 2021 Nov 28;6(1):bvab181
pubmed: 34934884
Basic Clin Pharmacol Toxicol. 2021 May;128(5):649-651
pubmed: 33548160
BMC Med Res Methodol. 2021 Mar 22;21(1):58
pubmed: 33752604
JAMA Intern Med. 2021 Jun 1;181(6):861-863
pubmed: 33720285
Risk Manag Healthc Policy. 2020 Dec 30;13:3179-3185
pubmed: 33408540
Clin Infect Dis. 2022 Jan 7;74(1):74-82
pubmed: 33693607
Med Care. 1982 Mar;20(3):266-76
pubmed: 7078285
Med Care. 1993 Mar;31(3):201-12
pubmed: 8450678
JDR Clin Trans Res. 2021 Apr;6(2):145-152
pubmed: 33423578

Auteurs

Laila Aboulatta (L)

College of Pharmacy, Rady Faculty of Health Sciences, University of Manitoba, Winnipeg, Canada.

Payam Peymani (P)

College of Pharmacy, Rady Faculty of Health Sciences, University of Manitoba, Winnipeg, Canada.

Christine Vaccaro (C)

College of Pharmacy, Rady Faculty of Health Sciences, University of Manitoba, Winnipeg, Canada.

Christine Leong (C)

College of Pharmacy, Rady Faculty of Health Sciences, University of Manitoba, Winnipeg, Canada.
Department of Psychiatry, College of Medicine, Rady Faculty of Health Sciences, University of Manitoba, Winnipeg, Canada.

Kaarina Kowalec (K)

College of Pharmacy, Rady Faculty of Health Sciences, University of Manitoba, Winnipeg, Canada.
Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden.

Joseph Delaney (J)

College of Pharmacy, Rady Faculty of Health Sciences, University of Manitoba, Winnipeg, Canada.
Department of Epidemiology, University of Washington, Seattle, WA, United States of America.

Jamie Falk (J)

College of Pharmacy, Rady Faculty of Health Sciences, University of Manitoba, Winnipeg, Canada.

Silvia Alessi-Severini (S)

College of Pharmacy, Rady Faculty of Health Sciences, University of Manitoba, Winnipeg, Canada.
Manitoba Centre for Health Policy, Winnipeg, Canada.

Basma Aloud (B)

College of Pharmacy, Rady Faculty of Health Sciences, University of Manitoba, Winnipeg, Canada.

Sherif Eltonsy (S)

College of Pharmacy, Rady Faculty of Health Sciences, University of Manitoba, Winnipeg, Canada.
The Children's Hospital Research Institute of Manitoba, Winnipeg, Canada.

Articles similaires

[Redispensing of expensive oral anticancer medicines: a practical application].

Lisanne N van Merendonk, Kübra Akgöl, Bastiaan Nuijen
1.00
Humans Antineoplastic Agents Administration, Oral Drug Costs Counterfeit Drugs

Smoking Cessation and Incident Cardiovascular Disease.

Jun Hwan Cho, Seung Yong Shin, Hoseob Kim et al.
1.00
Humans Male Smoking Cessation Cardiovascular Diseases Female
Humans United States Aged Cross-Sectional Studies Medicare Part C
1.00
Humans Yoga Low Back Pain Female Male

Classifications MeSH