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在与新冠疫情封锁相关的药物短缺期间,哮喘患者向基层医疗服务机构索要处方的经历和行为:对英国一个哮喘在线社区的定性分析见解

Experiences and behaviours of patients with asthma requesting prescriptions from primary care during medication shortages linked to the COVID-19 lockdown: insights from a qualitative analysis of a UK asthma online community.

作者信息

Ow Nadya L, Sadek Attalla Sara, Davies Gwyneth, Griffiths Chris J, De Simoni Anna

机构信息

Wolfson Institute of Population Health, Asthma UK Centre for Applied Research, (AUKCAR), Queen Mary University of London, London, UK.

Population Data Science, Asthma UK Centre for Applied Research, (AUKCAR), Swansea University Medical School, Swansea, UK.

出版信息

BJGP Open. 2022 Dec 20;6(4). doi: 10.3399/BJGPO.2021.0222. Print 2022 Dec.

Abstract

BACKGROUND

Inhaler shortages were reported in the UK following declaration of the COVID-19 pandemic, prompting advice against stockpiling.

AIM

To understand experiences and behaviours of patients with asthma requesting prescriptions from primary care during asthma medication shortages.

DESIGN & SETTING: UK asthma online community, between March and December 2020.

METHOD

Thematic analysis of posts identified using search terms 'shortage', 'out of stock', 'prescribe', and 'prescription'.

RESULTS

Sixty-seven participants were identified (48 adults, two children, 17 unstated age). Factors leading to increased requests included the following: stockpiling; early ordering; realising inhalers were out of date; and doctors prescribing multiple medication items. Patients' anxieties that could lead to stockpiling included the following: fear of asthma attacks leading to admission and acquiring COVID-19 in hospital; lack of dose counters on some inhalers; and believing a lower amount of drug is delivered in the last actuations. Strategies adopted in relation to shortages or changes in treatment owing to out-of-stock medications included the following: starting stockpiling; ordering prescriptions early; contacting medical professionals for advice or alternative prescriptions; getting 'emergency prescriptions'; ordering online or privately; seeking medications in different pharmacies; contacting drug manufacturers; and keeping track of number of doses left in canisters. No evidence was found of anxiety-triggered asthma symptoms that required medications due to fear of COVID-19. Participants seemed to disregard advice against stockpiling.

CONCLUSION

Better preparation is a key lesson from the COVID-19 pandemic. Clinicians, the pharmaceutical industry, and policymakers should use insights from this work to plan how to better manage medication shortages in future emergency situations.

摘要

背景

在新冠疫情宣布后,英国报告了吸入器短缺的情况,这促使人们提出不要囤积的建议。

目的

了解在哮喘药物短缺期间,从初级保健机构获取处方的哮喘患者的经历和行为。

设计与设置

2020年3月至12月期间的英国哮喘在线社区。

方法

对使用搜索词“短缺”“缺货”“开处方”和“处方”确定的帖子进行主题分析。

结果

确定了67名参与者(48名成年人、2名儿童、17名未说明年龄者)。导致需求增加的因素包括:囤积;提前订购;意识到吸入器过期;以及医生开具多种药物。可能导致囤积的患者焦虑包括:担心哮喘发作导致住院以及在医院感染新冠;一些吸入器没有剂量计数器;以及认为在最后几次按压中输送的药物量较少。因缺货药物导致的短缺或治疗变化所采取的策略包括:开始囤积;提前订购处方;联系医疗专业人员获取建议或替代处方;获取“紧急处方”;在线或私下订购;在不同药店寻找药物;联系药品制造商;以及跟踪药罐中剩余的剂量数。没有发现因担心新冠而导致焦虑引发需要用药的哮喘症状的证据。参与者似乎无视不要囤积的建议。

结论

做好更好的准备是新冠疫情带来的一个关键教训。临床医生、制药行业和政策制定者应利用这项工作的见解来规划如何在未来紧急情况下更好地管理药物短缺。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/8d5e/9904783/8812a7304dc6/bjgpopen-6-0222-f1.jpg

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