Lear-Claveras Ana, Clavería Ana, Couso-Viana Sabela, Nabbe Patrice, Oliván-Blázquez Bárbara
Institute for Health Research Aragón (IIS Aragón), Zaragoza, Spain.
I-Saúde Group, South Galicia Health Research Institute, Vigo, Spain.
Front Psychol. 2022 Apr 5;13:861643. doi: 10.3389/fpsyg.2022.861643. eCollection 2022.
The arrival of the COVID-19 pandemic modified the functions of Primary Care (PC) teams, which were forced to focus their resources on the diagnosis and treatment of SARS-CoV-2 infected patients. The disrupted healthcare of individuals with pre-existing mental disorders (depression or anxiety), as well as the psychological decompensation resulting from the lockdown caused by the COVID-19 pandemic, may have modified the use of drugs and health resources by these patients. The aim of this study is to determine the changes in these parameters, between the 6 months prior to the lockdown (09/14/2019 to 03/15/2020) and the 6 months following its end (05/03/2020 to 11/04/2020), in a population undergoing active treatment for depression or anxiety, according to the electronic clinical record.
Real world data observational study of 110,694 individuals aged >16 years suffering from active or undergoing treatment for depression or anxiety according to the electronic medical records of the Aragon Regional Health Service (Spain). Pharmacological variables [daily dose per inhabitant (DHD) dispensed by pharmacies of: anxiolytics, hypnotics/sedatives, and antidepressants] and variables related to the use of healthcare resources (number of primary and specialized healthcare visits) were considered. Student's -tests for paired samples were performed to analyze differences between periods (pre-post). The level of significance was established at 5% ( < 0.05).
The use of anxiolytic drugs increased as compared to its use over the 6 months prior to the lockdown. In contrast, the consumption of antidepressants was found to decrease. The use of health resources continued to be below pre-pandemic levels, 6 months post-lockdown end.
Changes in the use of health resources could have a negative impact on the parameters of these diseases. The increase in drug use, especially benzodiazepines, may suggest a worsening of the symptoms during the lockdown and in the subsequent months. It is a worrying sign, which points to the growth of this public health problem and the need for its prevention.
新冠疫情的到来改变了基层医疗(PC)团队的职能,这些团队被迫将资源集中于新冠病毒感染患者的诊断和治疗。患有既往精神障碍(抑郁症或焦虑症)患者的医疗保健受到干扰,以及新冠疫情导致的封锁所引发的心理失代偿,可能改变了这些患者的药物使用和医疗资源利用情况。本研究的目的是根据电子临床记录,确定在封锁前6个月(2019年9月14日至2020年3月15日)和封锁结束后6个月(2020年5月3日至2020年11月4日)期间,接受抑郁症或焦虑症积极治疗的人群中这些参数的变化。
根据西班牙阿拉贡地区卫生服务机构的电子病历,对110694名年龄大于16岁、患有活动性抑郁症或焦虑症或正在接受治疗的个体进行真实世界数据观察性研究。考虑了药理学变量[药房配发的每居民每日剂量(DHD):抗焦虑药、催眠药/镇静药和抗抑郁药]以及与医疗资源使用相关的变量(基层医疗和专科医疗就诊次数)。进行配对样本的学生t检验以分析不同时期(前后)之间的差异。显著性水平设定为5%(P<0.05)。
与封锁前6个月相比,抗焦虑药物的使用有所增加。相比之下,发现抗抑郁药的消费量有所下降。封锁结束6个月后,医疗资源的使用仍低于疫情前水平。
医疗资源使用的变化可能对这些疾病的参数产生负面影响。药物使用的增加,尤其是苯二氮䓬类药物的增加,可能表明封锁期间及随后几个月症状有所恶化。这是一个令人担忧的迹象,表明这个公共卫生问题在加剧,需要加以预防。