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在加拿大艾伯塔省,COVID-19 大流行前后精神健康药物的配药模式:一项中断时间序列分析。

Dispensing patterns of mental health medications before and during the COVID-19 pandemic in Alberta, Canada: An interrupted time series analysis.

机构信息

Faculty of Medicine & Dentistry, 3158University of Alberta, Edmonton, AB, Canada.

Poison and Drug Information Service, Alberta Health Services, Calgary, AB, Canada.

出版信息

Int J Psychiatry Med. 2023 Mar;58(2):172-184. doi: 10.1177/00912174221084818. Epub 2022 May 3.

Abstract

BACKGROUND

The COVID-19 pandemic has negatively impacted the general population in all aspects of life. Estimates of mental health medication dispensing in Alberta were investigated to elucidate areas of need within mental health and pharmacy practice during the pandemic.

METHODS

We employed an interrupted time series analysis using linear regression models to estimate community and outpatient medication dispensing trends of 46 medications used to treat mental health disorders. Three parameters were examined. The first was the medication dispensing slope before COVID-19. The second was the immediate effect of COVID-19 on dispensing (i.e., the difference in dispensing rate between the month before and after the first case of COVID-19) and the third was the medication dispensing slope during COVID-19.

RESULTS

Dispensing rates of 61% ( = 34) of the examined medications remained similar before and during the COVID-19 pandemic. However, eight medications (i.e., amitriptyline, escitalopram, fluoxetine, paroxetine, bupropion, desvenlafaxine, venlafaxine, and oxazepam) showed an immediate and significant increase in dispensing rate following the onset of the pandemic that was sustained over the first 13-months of the pandemic.

CONCLUSION

Initial increases in dispensing patterns of antidepressants may be attributed to a "stockpiling phenomenon" but the sustained higher levels of dispensing suggest an unfavorable shift in the population's mental health. Monitoring of medication dispensing patterns during COVID-19 may serve as a useful indicator of the population's mental health during the current pandemic and better prepare community pharmacists in future pandemic planning, medication dispensing strategies, and care of chronic medical conditions.

摘要

背景

COVID-19 大流行对所有人群的生活都产生了负面影响。本研究旨在评估艾伯塔省精神卫生药物的配药情况,以阐明大流行期间精神卫生和药学实践中的需求领域。

方法

我们采用线性回归模型的中断时间序列分析,估计用于治疗精神健康障碍的 46 种药物的社区和门诊药物配药趋势。考察了三个参数。第一个是 COVID-19 之前的药物配药斜率。第二个是 COVID-19 对配药的直接影响(即,COVID-19 首例病例前后的配药率差异),第三个是 COVID-19 期间的药物配药斜率。

结果

在所检查的药物中,61%(=34)的配药率在 COVID-19 大流行前后保持相似。然而,有八种药物(即阿米替林、依地普仑、氟西汀、帕罗西汀、安非他酮、去甲文拉法辛、文拉法辛和奥沙西泮)在大流行开始后,配药率立即显著增加,且在大流行的前 13 个月内持续增加。

结论

抗抑郁药配药模式的最初增加可能归因于“囤积现象”,但持续较高的配药水平表明人群的心理健康状况不利。在 COVID-19 期间监测药物配药模式可以作为当前大流行期间人群心理健康的有用指标,并为社区药剂师在未来的大流行规划、药物配药策略以及慢性病护理方面提供更好的准备。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/41e2/9903241/3da02283310a/10.1177_00912174221084818-fig1.jpg

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