School of Pharmacy and Biomolecular Sciences, RCSI University of Medicine and Health Sciences, Dublin, Ireland.
Somerville College, University of Oxford, Oxford, UK.
Basic Clin Pharmacol Toxicol. 2024 Feb;134(2):231-240. doi: 10.1111/bcpt.13958. Epub 2023 Nov 27.
The COVID-19 pandemic had a substantial impact on healthcare delivery, particularly in general practice. This study aimed to evaluate how dispensing of medications in primary care in Ireland changed following the COVID-19 pandemic's onset compared to expected trends. This interrupted time series study used data on medications prescribed in general practice 2016-2022 to patient eligible for state health cover, approximately one third of the population. Dispensing volumes for all therapeutic subgroups (ATC2 codes) and commonly dispensed medications were summarized. Pre-pandemic data were used to forecast expected trends (with 99% prediction intervals) using the Holt-Winters method, and these were compared to observed dispensing from March 2020 onwards. Many (31/77) therapeutic subgroups had dispensing significantly different from forecast in March 2020. Drugs for obstructive airway disease had the largest difference, with dispensing 26.2% (99%CI 19.5%-33.6%) higher than forecasted. Only two subgroups were significantly lower than forecasted, other gynaecologicals (17.7% lower, 99%CI 6.3%-26.6%) and dressings (11.6%, 99%CI 9.4%-41.6%). Dispensing of amoxicillin products and oral prednisolone were lower than forecasted in the months following the pandemic's onset, particularly during winter 2020/2021. There was a spike in dispensing for many long-term medications in March 2020, while pandemic restrictions likely contributed to reductions for other medications.
新冠疫情对医疗保健服务产生了重大影响,尤其是在全科医疗领域。本研究旨在评估与预期趋势相比,爱尔兰在新冠疫情爆发后,基层医疗中的药物配给情况发生了怎样的变化。这项中断时间序列研究使用了 2016 年至 2022 年期间在普通诊所开给符合国家健康保险条件的患者(约占总人口的三分之一)的药物处方数据。对所有治疗亚组(ATC2 代码)和常用药物的配给量进行了总结。使用霍尔特-温特斯(Holt-Winters)方法利用疫情前的数据对预期趋势(预测区间为 99%)进行预测,并将这些预测与 2020 年 3 月以后的实际配给情况进行比较。许多(31/77)治疗亚组的配给量与 2020 年 3 月的预测值存在显著差异。治疗气道阻塞性疾病的药物差异最大,实际配给量比预测值高 26.2%(99%CI 19.5%-33.6%)。仅有两个亚组的配给量显著低于预测值,分别是妇科用药(低 17.7%,99%CI 6.3%-26.6%)和敷料(低 11.6%,99%CI 9.4%-41.6%)。在疫情爆发后的几个月里,阿莫西林类药物和口服泼尼松的配给量低于预测值,尤其是在 2020/2021 年冬季。许多长期用药在 2020 年 3 月出现了配给高峰,而疫情限制可能导致其他药物的配给减少。