Assessing the impact of COVID-19 on prescription patterns and antibiotic use: Insights from three military health facilities.

Antibiotics Antimicrobial resistance COVID-19 Prescribing

Journal

Research in social & administrative pharmacy : RSAP
ISSN: 1934-8150
Titre abrégé: Res Social Adm Pharm
Pays: United States
ID NLM: 101231974

Informations de publication

Date de publication:
28 Oct 2023
Historique:
received: 15 06 2023
revised: 02 09 2023
accepted: 26 10 2023
medline: 3 11 2023
pubmed: 3 11 2023
entrez: 2 11 2023
Statut: aheadofprint

Résumé

The COVID-19 pandemic disrupted health systems globally and there are suggestions it impacted antibiotics prescribing patterns in clinical practice. This study aimed to assess the effects of the COVID-19 pandemic on the prescribing patterns in three Nigerian military health facilities and investigate the factors associated with antibiotic prescriptions. This was a two-year cross-sectional retrospective study. Three hospitals and a total of 11,590 prescriptions were purposively and conveniently sampled respectively. The World Health Organisation (WHO) and International Network of Rational Use of Drugs (INRUD) prescribing indicators were used to assess for polypharmacy, injection use, use of antibiotics, use of generic drugs and prescriptions from essential drug lists for the periods of the pandemic and before the pandemic. Indicators from both periods were compared for statistical significance using the independent t-test. Generalized linear modelling was applied to assess the factors associated with antibiotic prescriptions. The relationship between the receipt of antibiotics and independent variables was presented using incident risk ratios (IRR). Our findings showed that all five WHO/INRUD prescribing indicators were above the reference limit for the two-year study period. The study found there was a significant statistical difference between the COVID- and non-COVID-19 periods, with polypharmacy and antibiotic use indicators elevated during the pandemic compared to the latter. COVID-19 (IRR = 1.09), comorbidity (IRR = 1.74), pregnancy (IRR = 0.93), out-of-pocket payments (IRR = 1.10) and the inpatient department (IRR = 1.51) were associated with antibiotic prescriptions. This provides insight on impact of the pandemic on prescription patterns and advocates for stewardship programs in clinical settings to ensure the rational use of drugs.

Sections du résumé

BACKGROUND BACKGROUND
The COVID-19 pandemic disrupted health systems globally and there are suggestions it impacted antibiotics prescribing patterns in clinical practice.
OBJECTIVES OBJECTIVE
This study aimed to assess the effects of the COVID-19 pandemic on the prescribing patterns in three Nigerian military health facilities and investigate the factors associated with antibiotic prescriptions.
METHODS METHODS
This was a two-year cross-sectional retrospective study. Three hospitals and a total of 11,590 prescriptions were purposively and conveniently sampled respectively. The World Health Organisation (WHO) and International Network of Rational Use of Drugs (INRUD) prescribing indicators were used to assess for polypharmacy, injection use, use of antibiotics, use of generic drugs and prescriptions from essential drug lists for the periods of the pandemic and before the pandemic. Indicators from both periods were compared for statistical significance using the independent t-test. Generalized linear modelling was applied to assess the factors associated with antibiotic prescriptions. The relationship between the receipt of antibiotics and independent variables was presented using incident risk ratios (IRR).
RESULTS RESULTS
Our findings showed that all five WHO/INRUD prescribing indicators were above the reference limit for the two-year study period. The study found there was a significant statistical difference between the COVID- and non-COVID-19 periods, with polypharmacy and antibiotic use indicators elevated during the pandemic compared to the latter. COVID-19 (IRR = 1.09), comorbidity (IRR = 1.74), pregnancy (IRR = 0.93), out-of-pocket payments (IRR = 1.10) and the inpatient department (IRR = 1.51) were associated with antibiotic prescriptions.
CONCLUSIONS CONCLUSIONS
This provides insight on impact of the pandemic on prescription patterns and advocates for stewardship programs in clinical settings to ensure the rational use of drugs.

Identifiants

pubmed: 37919217
pii: S1551-7411(23)00465-5
doi: 10.1016/j.sapharm.2023.10.013
pii:
doi:

Types de publication

Journal Article

Langues

eng

Sous-ensembles de citation

IM

Informations de copyright

Copyright © 2023 The Authors. Published by Elsevier Inc. All rights reserved.

Déclaration de conflit d'intérêts

Declaration of competing interest The authors declare that they have no competing interests.

Auteurs

Mustapha Muhammed Abubakar (MM)

Directorate of Therapeutic Services, Medical Services Branch, Nigerian Air Force, Nigeria; The Boyd Orr Centre for Population and Ecosystem Health, School of One Health, Biodiversity and Veterinary Medicine, University of Glasgow, Glasgow, United Kingdom; National Defence College, Abuja, Nigeria.

Kathrin Loosli (K)

The Boyd Orr Centre for Population and Ecosystem Health, School of One Health, Biodiversity and Veterinary Medicine, University of Glasgow, Glasgow, United Kingdom.

Abdulmuminu Isah (A)

Department of Clinical Pharmacy and Pharmacy Management, University of Nigeria, Nsukka, Nigeria.

Mustafa Usman (M)

Directorate of Therapeutic Services, Medical Services Branch, Nigerian Air Force, Nigeria; National Defence College, Abuja, Nigeria.

Oluwatobi Fatokun (O)

Directorate of Therapeutic Services, Medical Services Branch, Nigerian Air Force, Nigeria.

Ibrahim Amidu (I)

Directorate of Therapeutic Services, Medical Services Branch, Nigerian Air Force, Nigeria.

Yusuf Ibrahim (Y)

The Boyd Orr Centre for Population and Ecosystem Health, School of One Health, Biodiversity and Veterinary Medicine, University of Glasgow, Glasgow, United Kingdom.

Mukhtar Dotun Ijaiya (MD)

Jhpiego Inc., Abuja, Nigeria.

Blessing Onyinye Ukoha-Kalu (BO)

Department of Clinical Pharmacy and Pharmacy Management, University of Nigeria, Nsukka, Nigeria; School of Medicine, University of Nottingham, Nottingham, England, United Kingdom. Electronic address: blessing.ukoha-kalu@nottingham.ac.uk.

Classifications MeSH