Visser Damian A, Everaerd Daphne S, Ellerbroek Hannah, Zinkstok Janneke R, Tendolkar Indira, Atsma Femke, Schellekens Arnt F A
Research Institute for Medical Innovation, Radboudumc, Nijmegen, The Netherlands.
Nijmegen Institute for Scientist-Practitioners in Addiction, Nijmegen, The Netherlands.
BJPsych Open. 2025 Mar 20;11(2):e64. doi: 10.1192/bjo.2024.867.
The COVID-19 pandemic and lockdowns had a significant impact on mental well-being and (mental) healthcare systems globally.
To describe trends and dynamics of out-patient prescribing of psychotropic medications during the COVID-19 pandemic in The Netherlands.
Dispensed psychotropic medication prescriptions during the COVID-19 pandemic from March 2020 to March 2022 were retrieved from national registry data. Numbers of total and incident dispensed prescriptions and defined daily doses (DDDs) were identified for six medication groups. Overall pandemic-related changes in prescribing trends were analysed using interrupted time-series analyses. Lockdown-related prescribing dynamics were described using monthly risk ratios.
No overall pandemic-related changes in prescribing were detected, except for alcohol addiction medication, for which a pre-pandemic decline in total dispensed prescriptions and DDDs levelled off during the pandemic: +10 prescriptions per week (95% CI 7-11, ≤ 0.001) and +111 DDDs per week (95% CI 56-165, = 0.001). Monthly prescribing dynamics showed transient increases in all medication groups during the second and third lockdown periods. There were decreases in dispensed incident antidepressant and opioid addiction medication prescriptions during the first lockdown (average risk ratios: 0.87 and 0.88 respectively), and DDDs of dispensed incident and total attention-deficit hyperactivity disorder medication prescriptions and incident benzodiazepine prescriptions were elevated from the end of the second lockdown (average risk ratios: 1.40, 1.12 and 1.17, respectively).
These findings raise concerns regarding possible over- and under-prescribing during the pandemic. Further understanding of specific factors driving these changes is necessary to help prepare for future mental health(care) challenges.
新冠疫情及封锁措施对全球心理健康和（心理）医疗系统产生了重大影响。
描述荷兰在新冠疫情期间精神药物门诊处方的趋势和动态。
从国家登记数据中检索2020年3月至2022年3月新冠疫情期间发放的精神药物处方。确定了六个药物组的总处方量和新处方量以及限定日剂量（DDD）。使用中断时间序列分析来分析疫情期间处方趋势的总体变化。使用月度风险比来描述与封锁相关的处方动态。
除酒精成瘾药物外，未发现与疫情相关的总体处方变化，在疫情期间，该药物组总发放处方量和DDD的疫情前下降趋势趋于平稳：每周增加10张处方（95%置信区间7-11，P≤0.001），每周增加111个DDD（95%置信区间56-165，P=0.001）。月度处方动态显示，在第二次和第三次封锁期间，所有药物组的处方量均出现短暂增加。在第一次封锁期间，新发放的抗抑郁药和阿片类药物成瘾药物处方量有所下降（平均风险比分别为0.87和0.88），从第二次封锁结束时起，新发放和总发放的注意力缺陷多动障碍药物处方量以及新发放的苯二氮䓬类药物处方量的DDD有所增加（平均风险比分别为1.40、1.12和1.17）。
这些发现引发了对疫情期间可能存在的处方过量和不足的担忧。有必要进一步了解推动这些变化的具体因素，以帮助应对未来的心理健康（护理）挑战。
