Pharmacoepidemiology and Drug Safety Research Group, Department of Pharmacy, Faculty of Mathematics and Natural Sciences, University of Oslo, Oslo, Norway.
Division of Biostatistics, Epidemiology and Public Health, Department of Statistics and Quantitative Methods, University of Milano-Bicocca, Milan, Italy.
Paediatr Perinat Epidemiol. 2024 Aug;38(6):450-460. doi: 10.1111/ppe.13046. Epub 2024 Feb 1.
The COVID-19 pandemic has affected children and adolescents in several ways, including worsened mental health, improvement of asthma, and increases in diabetes ketoacidosis. Less is known about how medication use in children and adolescents has been affected by the pandemic.
To explore how the COVID-19 pandemic affected drug utilisation in children and adolescents in Norway, Sweden, and Italy, by child age.
We conducted a longitudinal drug utilisation study among all children and adolescents (<18 years old) in Norway and Sweden and a nationwide paediatric database covering 3% of the paediatric population in Italy. We conducted an interrupted time-series analysis from January 2018 to December 2021, with March 2020 as the interruption point. Dispensing or prescription rates of antidepressants, anxiolytics, sleep medications, attention-deficit/hyperactivity disorder (ADHD) medications, insulin, and asthma medications were examined.
The study population in January 2018 consisted of 3,455,521 children and adolescents (136,188 from Italy, 1,160,431 from Norway, and 2,158,902 from Sweden). For sleep medications and insulin, there were only minor changes in level or trend in some age groups after March 2020. For asthma medications, the pandemic was associated with an immediate decrease in dispensing in Norway and Sweden (range of change in level: -19.2 to -3.7 dispensings per 1000 person-months), and an increasing trend in all countries afterward (range of change in trend: 0.3-6.4 dispensings per 1000 person-months), especially for the youngest age groups. Among adolescents, the pandemic was associated with an increased trend for ADHD medications, antidepressants, and anxiolytics in Norway and Sweden, but not in Italy.
The increasing trend of psychotropic medication dispensing, especially among adolescents after the start of the pandemic, is concerning and should be investigated further. Aside from a temporary effect on asthma medication dispensing, the pandemic did not greatly affect the dispensing of the medications investigated.
COVID-19 大流行以多种方式影响儿童和青少年，包括心理健康恶化、哮喘改善和糖尿病酮症酸中毒增加。关于大流行如何影响儿童和青少年的药物使用，了解较少。
通过儿童年龄，探讨 COVID-19 大流行如何影响挪威、瑞典和意大利儿童和青少年的药物使用。
我们对挪威和瑞典所有儿童和青少年（<18 岁）进行了一项纵向药物使用研究，并对意大利覆盖 3%儿科人群的全国儿科数据库进行了一项研究。我们进行了一项从 2018 年 1 月至 2021 年 12 月的中断时间序列分析，以 2020 年 3 月为中断点。检查了抗抑郁药、抗焦虑药、睡眠药物、注意力缺陷/多动障碍 (ADHD) 药物、胰岛素和哮喘药物的配药或处方率。
2018 年 1 月的研究人群包括 3455521 名儿童和青少年（意大利 136188 名，挪威 1160431 名，瑞典 2158902 名）。对于睡眠药物和胰岛素，在 2020 年 3 月之后，一些年龄组的水平或趋势只有很小的变化。对于哮喘药物，大流行与挪威和瑞典配药的立即减少有关（水平变化范围：-19.2 至-3.7 配药/1000 人月），此后所有国家的趋势都呈上升趋势（趋势变化范围：0.3-6.4 配药/1000 人月），尤其是在最年轻的年龄组。在青少年中，大流行与挪威和瑞典 ADHD 药物、抗抑郁药和抗焦虑药的趋势增加有关，但意大利没有。
大流行开始后，精神药物配药的上升趋势，尤其是青少年的上升趋势令人担忧，应进一步调查。除了对哮喘药物配药的临时影响外，大流行并未对所研究药物的配药产生重大影响。
