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爱尔兰共和国 COVID-19 大流行期间发病前后药物使用趋势:一项中断时间序列研究。

Trends in medication use at the onset of and during the COVID-19 pandemic in the Republic of Ireland: An interrupted time series study.

机构信息

School of Pharmacy and Biomolecular Sciences, RCSI University of Medicine and Health Sciences, Dublin, Ireland.

Somerville College, University of Oxford, Oxford, UK.

出版信息

Basic Clin Pharmacol Toxicol. 2024 Feb;134(2):231-240. doi: 10.1111/bcpt.13958. Epub 2023 Nov 27.

Abstract

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.

摘要

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。

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