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COVID-19 大流行对慢性心血管治疗门诊患者治疗连续性的影响。

Impact of the COVID-19 Pandemic on the Therapeutic Continuity among Outpatients with Chronic Cardiovascular Therapies.

机构信息

Epidemiology and Preventive Pharmacology Service (SEFAP), Department of Pharmacological and Biomolecular Sciences, University of Milan, Via Balzaretti 9, 20133 Milan, Italy.

IRCCS MultiMedica, Via Milanese 300, Sesto S. Giovanni, 20099 Milan, Italy.

出版信息

Int J Environ Res Public Health. 2022 Sep 24;19(19):12101. doi: 10.3390/ijerph191912101.

Abstract

The COVID-19 pandemic poses major challenges to healthcare systems. We aimed to investigate the impact of the pandemic on prescription and adherence patterns of chronic cardiovascular therapies (lipid-lowering [LL], oral antidiabetic drugs [AD], and antihypertensives [AH]) using administrative pharmaceutical databases. For each treatment, two cohorts of prevalent cases in 2019 and 2020 were compared. We evaluated the percentage change in dispensed packages and treatment adherence as a proportion of days covered (PDC). For all therapies, an increase was observed during March-April 2020 (LL: +4.52%; AD: +2.72%; AH: +1.09%), with a sharp decrease in May-June 2020 (LL: -8.40%; AD: -12.09%; AH: -10.54%) compared to 2019. The impact of the COVID-19 pandemic on chronic cardiovascular treatments appears negligible on adherence: 533,414 patients showed high adherence to LL (PDC ≥ 80%) in January-February 2020, and 2.29% became poorly adherent (PDC < 20%) in the following four-month period (vs. 1.98% in 2019). A similar increase was also observed for AH (1.25% with poor adherence in 2020 vs. 0.93% in 2019). For AD, the increase was restrained (1.55% with poor adherence in 2020 vs. 1.37% in 2019). The rush to supply drugs at the beginning of lockdown preserved the continuity of chronic cardiovascular therapies.

摘要

COVID-19 大流行对医疗系统构成重大挑战。我们旨在使用行政制药数据库研究大流行对慢性心血管治疗(降脂 [LL]、口服抗糖尿病药物 [AD] 和抗高血压药物 [AH])的处方和依从模式的影响。对于每种治疗方法,比较了 2019 年和 2020 年的两个常见病例队列。我们评估了分配包裹的百分比变化和作为覆盖天数(PDC)比例的治疗依从性。对于所有治疗方法,2020 年 3 月至 4 月期间观察到增加(LL:+4.52%;AD:+2.72%;AH:+1.09%),而 2020 年 5 月至 6 月期间急剧下降(LL:-8.40%;AD:-12.09%;AH:-10.54%)与 2019 年相比。COVID-19 大流行对慢性心血管治疗的影响在依从性方面似乎微不足道:2020 年 1 月至 2 月,533,414 名患者对 LL(PDC≥80%)表现出高度依从性,而在随后的四个月中,有 2.29%的患者变得不依从(PDC<20%)(与 2019 年的 1.98%相比)。AH 也观察到类似的增加(2020 年有 1.25%的患者不依从,而 2019 年为 0.93%)。对于 AD,这种增加受到限制(2020 年有 1.55%的患者不依从,而 2019 年为 1.37%)。封锁开始时急于供应药物,保持了慢性心血管治疗的连续性。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/a421/9566639/34e86f877a0c/ijerph-19-12101-g001a.jpg

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